JP7085554B2 - Deployable intervertebral fusion device - Google Patents

Description

Cross-references This application is filed on January 10, 2017, US Provisional Application No. 62 / 444,663 (agent reference number 51624-703. 101), and filed on March 14, 2017, No. 62 / 471,206 (agent). Claims the interests of Person Reference No. 51624-703. 102) and No. 62 / 481,565 filed on April 4, 2017 (agent reference number 51624-703. 103); all of these contents are by reference to the book. Incorporated in the specification.

Background The present disclosure relates to medical devices and methods, more preferably devices and methods for promoting intervertebral fusion, and more specifically, deployments that can be inserted between adjacent vertebrae to facilitate the fusion process. Regarding possible healing devices.

A common procedure for dealing with pain associated with degenerated discs due to various factors such as trauma or aging is the use of an intervertebral fusion device to fuse one or more adjacent vertebral bodies. .. Generally, the disc is first partially or completely removed to fuse adjacent vertebral bodies. Then, typically, an intervertebral fusion device is inserted between neighboring vertebrae to maintain normal disc spacing, restore spinal stability, and thereby promote intervertebral fusion.

There are several conventional healing devices and methodologies known in the art to achieve intervertebral fusion. These include screw and rod arrangements, solid bone implants, and fusion devices that typically include cages or other implant mechanisms packed with bone and / or bone growth inducers. These devices are implanted between adjacent vertebral bodies to fuse the vertebral bodies to each other and reduce the associated pain.

However, there are challenges associated with known conventional healing devices and methodologies. For example, the current method for installing a conventional healing device is to stretch the adjacent vertebral body to return the pathological disc space to its normal or healthy height prior to implantation of the healing device. May need to be done. Once the healing device is inserted, in order to maintain this height, the healing device is usually sized to be higher than the initial extension height. This height difference can make it difficult for the surgeon to place the fusion device in the stretched intervertebral space.

Thus, there is a need for a healing device that can be installed in the disc space at a minimum, unobtrusive height, and a healing device that can maintain the normal distance between adjacent vertebral bodies when implanted. It is said that.

One of the most common postoperative complications of facet fusion surgery is facet graft or cage subsidence that is minimized or mitigated by using a larger footprint facet cage or graft. This is usually difficult because it is often advantageous to utilize the smallest surgical access passages that can achieve the purpose of the surgery in order to minimize the trauma and morbidity associated with spinal surgery. .. Therefore, there is a need for a healing device that can be inserted through a relatively small surgical corridor and then deployed to a larger footprint suitable for resisting subsidence.

The device is inserted with minimal or no intervertebral extension and with minimal width through a relatively small surgical passage, where both of these criteria are preferably met, and then deployed. With a larger footprint suitable for resisting subsidence, and for the purpose of reducing pressure on nerve elements and maintaining intervertebral height, as well as maintaining the desired alignment of adjacent vertebral bodies. Maintained at a higher height suitable for. At least some of these objectives will be achieved by the exemplary embodiments disclosed herein.

Explanation of background technology
8,568,481; 8,926,704; 9,474,625; 9,138,328; 9,445,918; 2016/0317315; 2016/0324654; US20170056200A1; US9801734; US9795493; US9717601; US6821298; US20110035011A1; US9445918; US9480574; US6176882; US8105382;

Overview Optionally, in any embodiment, the present disclosure is inserted with minimal or no intervertebral extension and with minimal width through a relatively small surgical corridor, then deploys and resists subsidence. A deployable fusion device capable of reducing pressure on nerve elements and maintaining intervertebral height, as well as maintaining the desired alignment of adjacent vertebral bodies, with a larger footprint suitable for offer.

In one embodiment, the fusion device is a proximal wedge, a distal wedge, a first ramp, a second ramp, a third ramp, a fourth ramp, a first end plate, a second end plate, a third. Includes holding members designed to constrain the linear motion of the actuator with respect to the end plate, fourth end plate, actuator and proximal wedge. The actuator pulls the proximal and distal wedges together or away from each other, forcing the first ramp away from the fourth ramp, and forcing the second ramp from the third ramp. Releasing, forcing the first lamp away from or closer to the second lamp, forcing the third lamp away from or closer to the fourth lamp As a result, the first end plate, the second end plate, the third end plate and the fourth end plate are moved outward from each other to the unfolding configuration.

The first aspect provided herein is a deployable fusion device for two adjacent intervertebral implants, the device being: an actuator comprising a drive mechanism and a vertical axis; coupled to the actuator. Includes wedge assembly; slidably coupled lamp assembly to wedge assembly; top end plate assembly slidably coupled to lamp assembly; and section end plate assembly slidably coupled to lamp assembly.

Optionally, in any embodiment, the device has a width that includes at least one outer width of the upper end plate assembly and the lower end plate assembly. Optionally, in any embodiment, the device has a height that includes an external distance between the upper end plate assembly and the lower end plate assembly. Optionally, in any embodiment, the actuation of the drive mechanism by the first actuation number in the first actuation direction increases the width without increasing the height. Optionally, in any embodiment, the actuation of the drive mechanism by a second actuation number exceeding the first actuation number in the first actuation direction increases at least one of height and width.

Optionally, in any embodiment, the first actuation number is from about 0.5 actuation to about 10 actuation. Optionally, in any embodiment, the first actuation number is at least about 0.5 actuation. Optionally, in any embodiment, the first actuation number is up to about 10 actuations. Optionally, in any embodiment, the first actuation number is from about 0.5 act to about 1 act, about 0.5 act to about 1.5 act, about 0.5 act to about 2 act, about 0. 5 operations to about 2.5 operations, about 0.5 operations to about 3 operations, about 0.5 operations to about 3.5 operations, about 0.5 operations to about 4 operations, about 0.5 operations to about 5 operations , About 0.5 operation to about 6 operation, about 0.5 operation to about 8 operation, about 0.5 operation to about 10 operation, about 1 operation to about 1.5 operation, about 1 operation to about 2 operation, about 1 operation to about 2.5 operation, about 1 operation to about 3 operation, about 1 operation to about 3.5 operation, about 1 operation to about 4 operation, about 1 operation to about 5 operation, about 1 operation to about 6 operation , About 1 operation to about 8 operations, about 1 operation to about 10 operations, about 1.5 operations to about 2 operations, about 1.5 operations to about 2.5 operations, about 1.5 operations to about 3 operations, about 1.5 operation to about 3.5 operation, about 1.5 operation to about 4 operation, about 1.5 operation to about 5 operation, about 1.5 operation to about 6 operation, about 1.5 operation to about 8 operation , About 1.5 operation to about 10 operation, about 2 operation to about 2.5 operation, about 2 operation to about 3 operation, about 2 operation to about 3.5 operation, about 2 operation to about 4 operation, about 2 operation ~ About 5 operations, about 2 operations ~ about 6 operations, about 2 operations ~ about 8 operations, about 2 operations ~ about 10 operations, about 2.5 operations ~ about 3 operations, about 2.5 operations ~ about 3.5 operations , About 2.5 operation to about 4 operation, about 2.5 operation to about 5 operation, about 2.5 operation to about 6 operation, about 2.5 operation to about 8 operation, about 2.5 operation to about 10 operation , About 3 operations to about 3.5 operations, about 3 operations to about 4 operations, about 3 operations to about 5 operations, about 3 operations to about 6 operations, about 3 operations to about 8 operations, about 3 operations to about 10 operations , About 3.5 operation to about 4 operation, about 3.5 operation to about 5 operation, about 3.5 operation to about 6 operation, about 3.5 operation to about 8 operation, about 3.5 operation to about 10 operation , About 4 to about 5 operations, about 4 to about 6 operations, about 4 to about 8 operations, about 4 to about 10 operations, about 5 to about 6 operations, about 5 to about 8 operations, about 5 operations to about 10 operations, about 6 operations to about 8 operations, about 6 operations to about 10 operations, or about 8 operations to about 10 operations. Optionally, in any embodiment, the first number of operations is about 0.5 operation, about 1 operation, about 1.5 operation, about 2 operation, about 2.5 operation, about 3 operation, about 3.5 operation. , About 4 operations, about 5 operations, about 6 operations, about 8 operations, or about 10 operations.

Optionally, in any embodiment, the second actuation number is from about 0.5 actuation to about 10 actuation. Optionally, in any embodiment, the second actuation number is at least about 0.5 actuation. Optionally, in any embodiment, the second actuation number is up to about 10 actuations. Optionally, in any embodiment, the second actuation number is from about 0.5 act to about 1 act, about 0.5 act to about 1.5 act, about 0.5 act to about 2 act, about 0. 5 operations to about 2.5 operations, about 0.5 operations to about 3 operations, about 0.5 operations to about 3.5 operations, about 0.5 operations to about 4 operations, about 0.5 operations to about 5 operations , About 0.5 operation to about 6 operation, about 0.5 operation to about 8 operation, about 0.5 operation to about 10 operation, about 1 operation to about 1.5 operation, about 1 operation to about 2 operation, about 1 operation to about 2.5 operation, about 1 operation to about 3 operation, about 1 operation to about 3.5 operation, about 1 operation to about 4 operation, about 1 operation to about 5 operation, about 1 operation to about 6 operation , About 1 operation to about 8 operations, about 1 operation to about 10 operations, about 1.5 operations to about 2 operations, about 1.5 operations to about 2.5 operations, about 1.5 operations to about 3 operations, about 1.5 operation to about 3.5 operation, about 1.5 operation to about 4 operation, about 1.5 operation to about 5 operation, about 1.5 operation to about 6 operation, about 1.5 operation to about 8 operation , About 1.5 operation to about 10 operation, about 2 operation to about 2.5 operation, about 2 operation to about 3 operation, about 2 operation to about 3.5 operation, about 2 operation to about 4 operation, about 2 operation ~ About 5 operations, about 2 operations ~ about 6 operations, about 2 operations ~ about 8 operations, about 2 operations ~ about 10 operations, about 2.5 operations ~ about 3 operations, about 2.5 operations ~ about 3.5 operations , About 2.5 operation to about 4 operation, about 2.5 operation to about 5 operation, about 2.5 operation to about 6 operation, about 2.5 operation to about 8 operation, about 2.5 operation to about 10 operation , About 3 operations to about 3.5 operations, about 3 operations to about 4 operations, about 3 operations to about 5 operations, about 3 operations to about 6 operations, about 3 operations to about 8 operations, about 3 operations to about 10 operations , About 3.5 operation to about 4 operation, about 3.5 operation to about 5 operation, about 3.5 operation to about 6 operation, about 3.5 operation to about 8 operation, about 3.5 operation to about 10 operation , About 4 to about 5 operations, about 4 to about 6 operations, about 4 to about 8 operations, about 4 to about 10 operations, about 5 to about 6 operations, about 5 to about 8 operations, about 5 operations to about 10 operations, about 6 operations to about 8 operations, about 6 operations to about 10 operations, or about 8 operations to about 10 operations. Optionally, in any embodiment, the second actuation number is about 0.5 actuation, about 1 actuation, about 1.5 actuation, about 2 actuation, about 2.5 actuation, about 3 actuation, about 3.5 actuation, About 4 operations, about 5 operations, about 6 operations, about 8 operations, or about 10 operations.

Optionally, in any embodiment, the actuation of the drive mechanism by a second actuation number exceeding the first actuation number in the first actuation direction increases both height and width. Optionally, in any embodiment, the actuation of the drive mechanism by a third actuation number exceeding the first and second actuation numbers in the first actuation direction increases the height without increasing the width.

Optionally, in any embodiment, the width of the device reaches the limit when the drive mechanism is actuated by at least the first actuation number. Optionally, in any embodiment, the height of the device reaches the limit when the drive mechanism is actuated by at least the first and second actuation numbers.

Optionally, in any embodiment, operating the drive mechanism in the first actuation direction by at least the first actuation number increases the height of the device by about 30% to about 400%. Optionally, in any embodiment, actuating the drive mechanism in the first actuation direction by at least the first actuation number increases the height of the device by at least about 30%. Optionally, in any embodiment, actuating the drive mechanism in the first actuation direction by at least the first actuation number increases the height of the device by up to about 400%. Optionally, in any embodiment, when the drive mechanism is actuated in the first actuation direction by at least the first actuation number, the height of the device is about 30% to about 50%, about 30% to about 75%. About 30% to about 100%, about 30% to about 125%, about 30% to about 150%, about 30% to about 175%, about 30% to about 200%, about 30% to about 250%, about 30 % To about 300%, about 30% to about 350%, about 30% to about 400%, about 50% to about 75%, about 50% to about 100%, about 50% to about 125%, about 50% to About 150%, about 50% to about 175%, about 50% to about 200%, about 50% to about 250%, about 50% to about 300%, about 50% to about 350%, about 50% to about 400 %, About 75% to about 100%, About 75% to about 125%, About 75% to about 150%, About 75% to about 175%, About 75% to about 200%, About 75% to about 250%, About 75% to about 300%, about 75% to about 350%, about 75% to about 400%, about 100% to about 125%, about 100% to about 150%, about 100% to about 175%, about 100 % To about 200%, about 100% to about 250%, about 100% to about 300%, about 100% to about 350%, about 100% to about 400%, about 125% to about 150%, about 125% to About 175%, about 125% to about 200%, about 125% to about 250%, about 125% to about 300%, about 125% to about 350%, about 125% to about 400%, about 150% to about 175 %, About 150% to about 200%, About 150% to about 250%, About 150% to about 300%, About 150% to about 350%, About 150% to about 400%, About 175% to about 200%, About 175% to about 250%, about 175% to about 300%, about 175% to about 350%, about 175% to about 400%, about 200% to about 250%, about 200% to about 300%, about 200 % To about 350%, about 200% to about 400%, about 250% to about 300%, about 250% to about 350%, about 250% to about 400%, about 300% to about 350%, about 300% to Increases by about 400%, or about 350% to about 400%. Optionally, in any embodiment, when the drive mechanism is actuated in the first actuation direction by at least the first actuation number, the height of the device is about 30%, about 50%, about 75%, about 100%, about. Increases by 125%, about 150%, about 175%, about 200%, about 250%, about 300%, about 350%, or about 400%.

Optionally, in any embodiment, actuating the drive mechanism in the first actuation direction by at least the first and second actuations increases the width of the device by about 14% to about 150%. Optionally, in any embodiment, actuating the drive mechanism in the first actuation direction by at least the first and second actuations increases the width of the device by at least about 14%. Optionally, in any embodiment, actuating the drive mechanism in the first actuation direction by at least the first and second actuations increases the width of the device by up to about 150%. Optionally, in any embodiment, when the drive mechanism is actuated in the first actuation direction by at least the first and second actuation numbers, the width of the device is about 14% to about 20%, about 14% to about 30. %, About 14% to about 40%, about 14% to about 50%, about 14% to about 60%, about 14% to about 70%, about 14% to about 80%, about 14% to about 100%, About 14% to about 120%, about 14% to about 140%, about 14% to about 150%, about 20% to about 30%, about 20% to about 40%, about 20% to about 50%, about 20 % To about 60%, about 20% to about 70%, about 20% to about 80%, about 20% to about 100%, about 20% to about 120%, about 20% to about 140%, about 20% to About 150%, about 30% to about 40%, about 30% to about 50%, about 30% to about 60%, about 30% to about 70%, about 30% to about 80%, about 30% to about 100 %, About 30% to about 120%, about 30% to about 140%, about 30% to about 150%, about 40% to about 50%, about 40% to about 60%, about 40% to about 70%, About 40% to about 80%, about 40% to about 100%, about 40% to about 120%, about 40% to about 140%, about 40% to about 150%, about 50% to about 60%, about 50 % To about 70%, about 50% to about 80%, about 50% to about 100%, about 50% to about 120%, about 50% to about 140%, about 50% to about 150%, about 60% to About 70%, about 60% to about 80%, about 60% to about 100%, about 60% to about 120%, about 60% to about 140%, about 60% to about 150%, about 70% to about 80 %, About 70% to about 100%, About 70% to about 120%, About 70% to about 140%, About 70% to about 150%, About 80% to about 100%, About 80% to about 120%, About 80% to about 140%, about 80% to about 150%, about 100% to about 120%, about 100% to about 140%, about 100% to about 150%, about 120% to about 140%, about 120 % To about 150%, or about 140% to about 150% increase.
Optionally, in any embodiment, when the drive mechanism is actuated in the first actuation direction by at least the first and second actuation numbers, the width of the device is about 14%, about 20%, about 30%, about 40. %, About 50%, about 60%, about 70%, about 80%, about 100%, about 120%, about 140%, or about 150% increase.

Optionally, in any embodiment, the actuator has a distal end and a proximal end.
Optionally, in any embodiment, at least a portion of the distal end comprises a first thread mechanism. Optionally, in any embodiment, at least a portion of the proximal end comprises a second thread mechanism. Optionally, in any embodiment, the proximal end comprises a drive mechanism. Optionally, in any embodiment, at least one of the first thread mechanism and the second thread mechanism comprises a thread arranged outside the perimeter of the actuator. Optionally, in any embodiment, the first thread mechanism and the second thread mechanism have opposite threading directions.

Optionally, in any embodiment, the wedge assembly comprises a distal wedge and a proximal wedge. Optionally, in any embodiment, the actuation of the drive mechanism in the first direction brings the distal wedge and the proximal wedge closer to each other. Optionally, in any embodiment, the distal wedge comprises a third thread mechanism, the third thread mechanism is threadably coupled to the first thread mechanism. Optionally, in any embodiment, the proximal wedge comprises a fourth thread mechanism, the fourth thread mechanism being screwed into a second thread mechanism. Optionally, in any embodiment, the third thread mechanism comprises a thread located inside the distal wedge. Optionally, in any embodiment, the fourth thread mechanism comprises a thread located inside the proximal wedge.

Optionally, in any embodiment, the lamp assembly comprises a first distal lamp, a second distal lamp, a first proximal lamp, and a second proximal lamp. Optionally, in any embodiment, the slidable connection between the wedge assembly and the ramp assembly, the ramp assembly and the upper end plate assembly, and at least one of the ramp assembly and the lower end plate assembly is at an angular position across the vertical axis . ..

Optionally, in any embodiment, the angle across the vertical axis is from about 0 ° to about 90 °. Optionally, in any embodiment, the angle across the vertical axis is at least about 0 °.
Optionally, in any embodiment, the angle across the vertical axis is up to about 90 °. Optionally, in any embodiment, the angles across the vertical axis are about 0 ° to about 1 °, about 0 ° to about 5 °, about 0 ° to about 10 °, about 0 ° to about 20 °, about 0 °. ~ About 30 °, about 0 ° ~ about 40 °, about 0 ° ~ about 50 °, about 0 ° ~ about 60 °, about 0 ° ~ about 70 °, about 0 ° ~ about 80 °, about 0 ° ~ about 90 °, about 1 ° to about 5 °, about 1 ° to about 10 °, about 1 ° to about 20 °, about 1 ° to about 30 °, about 1 ° to about 40 °, about 1 ° to about 50 ° , About 1 ° to about 60 °, about 1 ° to about 70 °, about 1 ° to about 80 °, about 1 ° to about 90 °, about 5 ° to about 10 °, about 5 ° to about 20 °, about 5 ° to about 30 °, about 5 ° to about 40 °, about 5 ° to about 50 °, about 5 ° to about 60 °, about 5 ° to about 70 °, about 5 ° to about 80 °, about 5 ° ~ About 90 °, about 10 ° ~ about 20 °, about 10 ° ~ about 30 °, about 10 ° ~ about 40 °, about 10 ° ~ about 50 °, about 10 ° ~ about 60 °, about 10 ° ~ about 70 °, about 10 ° to about 80 °, about 10 ° to about 90 °, about 20 ° to about 30 °, about 20 ° to about 40 °, about 20 ° to about 50 °, about 20 ° to about 60 ° , About 20 ° to about 70 °, about 20 ° to about 80 °, about 20 ° to about 90 °, about 30 ° to about 40 °, about 30 ° to about 50 °, about 30 ° to about 60 °, about 30 ° to about 70 °, about 30 ° to about 80 °, about 30 ° to about 90 °, about 40 ° to about 50 °, about 40 ° to about 60 °, about 40 ° to about 70 °, about 40 ° ~ About 80 °, about 40 ° ~ about 90 °, about 50 ° ~ about 60 °, about 50 ° ~ about 70 °, about 50 ° ~ about 80 °, about 50 ° ~ about 90 °, about 60 ° ~ about 70 ° to about 60 ° to about 80 °, about 60 ° to about 90 °, about 70 ° to about 80 °, about 70 ° to about 90 °, or about 80 ° to about 90 °. Optionally, in any embodiment, the angles across the vertical axis are about 0 °, about 1 °, about 5 °, about 10 °, about 20 °, about 30 °, about 40 °, about 50 °, about 60 °. , About 70 °, about 80 ° or about 90 °.

Optionally, in any embodiment, a slideable connection between the wedge assembly and the ramp assembly, the ramp assembly and the upper end plate assembly, and at least one of the ramp assembly and the lower end plate assembly comprises protrusions and slots. Optionally, in any embodiment, the protrusion extends from at least one of the wedge assembly, ramp assembly, upper end plate assembly and lower end plate assembly, and the slot is at least one of the upper end plate assembly and the lower end plate assembly. Placed in.
Optionally, in any embodiment, the protrusions include pins, ridges, dimples, bolts, screws, bearings or any combination thereof. Optionally, in any embodiment, the slot comprises a through slot, a blind slot, a t-slot, a v-slot, a groove or any combination thereof.

Optionally, in any embodiment, the drive mechanism comprises a recessed area configured to receive the drive instrument. Optionally, in any embodiment, the recessed area is a slot, Philips, positive drive, flareson, Robertson, 12-point flange, hex socket, security hex socket, star drive, security Torx®, ta, three points. Includes, three wings, spanner head, clutch, one way, double square, triple square, polydrive, spline drive, double hex, bristol, thread, friction fit, or pentalobe recess. Optionally, in any embodiment, includes a protubalance configured to extend from the drive mechanism and be coupled to the drive instrument. Optionally, in any embodiment, the protubalance comprises a hexagonal, hexarobula, threaded or square protubalance.

Optionally, in any embodiment, the upper end plate assembly comprises a first end plate and a second end plate, and the lower end plate assembly comprises a third end plate and a fourth end plate. Optionally, in any embodiment, a first end plate and a second end plate, a third end plate and a fourth end plate, a first proximal lamp and a second proximal lamp, and a first. At least one of the distal lamp and the second distal lamp has mirror equivalence. Optionally, in any embodiment, at least one of the second end plate and the fourth end plate is larger than at least one of the first end plate and the third end plate. Optionally, in any embodiment, the outer surface of at least one of the first end plate, the second end plate, the third end plate and the fourth end plate comprises a texture configured to grip the vertebrae. .. Optionally, in any embodiment, the texture ring comprises teeth, protubalance, rough surface areas, metal coatings, ceramic coatings, keels, spikes, protrusions, grooves or any combination thereof.

Optionally, in any embodiment, at least one of the actuator, wedge assembly, lamp assembly, upper end plate assembly and lower end plate assembly is titanium, cobalt, stainless steel, tantalum, platinum, PEEK, PEKK, carbon fiber, barium sulfate. , Hydroxyapatite, ceramic, zirconium oxide, silicon nitride, carbon, bone implant pieces, desalted bone matrix products, synthetic bone substitutes, bone forming agents, bone growth-inducing materials or any combination thereof.

A second aspect provided herein is a deployable fusion system for implantation between two adjacent vertebrae, the system including an inserter and a deployable fusion device. Includes an actuator that includes a drive mechanism and a vertical axis; a wedge assembly; a lamp assembly; an upper end plate assembly; and a lower end plate assembly; where the device is a first end plate and a third end plate, as well as a second. It has a width that includes an external distance between the two end plates and at least one of the fourth end plates; the device has a first end plate and a second end plate, as well as a third end plate and a fourth end plate. It has a height that includes an external distance between at least one of the end plates; the operation of the drive mechanism by the first number of operations in the first direction of operation increases the width without increasing the height; and the first. The actuation of the drive mechanism by a second actuation number exceeding the first actuation number in one actuation direction increases at least one of height and width.

Optionally, in any embodiment, the actuation of the drive mechanism by a second actuation number exceeding the first actuation number in the first actuation direction increases both height and width. Optionally, in any embodiment, the actuation of the drive mechanism by a second actuation number exceeding the first actuation number in the first actuation direction increases the height without increasing the width.

Optionally, in any embodiment, the width of the device reaches the limit when the drive mechanism is actuated by at least the first actuation number. Optionally, in any embodiment, the height of the device reaches the limit when the drive mechanism is actuated by at least the first and second actuation numbers.

Optionally, in any embodiment, the first actuation number is from about 0.5 actuation to about 10 actuation. Optionally, in any embodiment, the first actuation number is at least about 0.5 actuation. Optionally, in any embodiment, the first actuation number is up to about 10 actuations. Optionally, in any embodiment, the first actuation number is from about 0.5 act to about 1 act, about 0.5 act to about 1.5 act, about 0.5 act to about 2 act, about 0. 5 operations to about 2.5 operations, about 0.5 operations to about 3 operations, about 0.5 operations to about 3.5 operations, about 0.5 operations to about 4 operations, about 0.5 operations to about 5 operations , About 0.5 operation to about 6 operation, about 0.5 operation to about 8 operation, about 0.5 operation to about 10 operation, about 1 operation to about 1.5 operation, about 1 operation to about 2 operation, about 1 operation to about 2.5 operation, about 1 operation to about 3 operation, about 1 operation to about 3.5 operation, about 1 operation to about 4 operation, about 1 operation to about 5 operation, about 1 operation to about 6 operation , About 1 operation to about 8 operations, about 1 operation to about 10 operations, about 1.5 operations to about 2 operations, about 1.5 operations to about 2.5 operations, about 1.5 operations to about 3 operations, about 1.5 operation to about 3.5 operation, about 1.5 operation to about 4 operation, about 1.5 operation to about 5 operation, about 1.5 operation to about 6 operation, about 1.5 operation to about 8 operation , About 1.5 operation to about 10 operation, about 2 operation to about 2.5 operation, about 2 operation to about 3 operation, about 2 operation to about 3.5 operation, about 2 operation to about 4 operation, about 2 operation ~ About 5 operations, about 2 operations ~ about 6 operations, about 2 operations ~ about 8 operations, about 2 operations ~ about 10 operations, about 2.5 operations ~ about 3 operations, about 2.5 operations ~ about 3.5 operations , About 2.5 operation to about 4 operation, about 2.5 operation to about 5 operation, about 2.5 operation to about 6 operation, about 2.5 operation to about 8 operation, about 2.5 operation to about 10 operation , About 3 operations to about 3.5 operations, about 3 operations to about 4 operations, about 3 operations to about 5 operations, about 3 operations to about 6 operations, about 3 operations to about 8 operations, about 3 operations to about 10 operations , About 3.5 operation to about 4 operation, about 3.5 operation to about 5 operation, about 3.5 operation to about 6 operation, about 3.5 operation to about 8 operation, about 3.5 operation to about 10 operation , About 4 to about 5 operations, about 4 to about 6 operations, about 4 to about 8 operations, about 4 to about 10 operations, about 5 to about 6 operations, about 5 to about 8 operations, about 5 operations to about 10 operations, about 6 operations to about 8 operations, about 6 operations to about 10 operations, or about 8 operations to about 10 operations. Optionally, in any embodiment, the first number of operations is about 0.5 operation, about 1 operation, about 1.5 operation, about 2 operation, about 2.5 operation, about 3 operation, about 3.5 operation. , About 4 operations, about 5 operations, about 6 operations, about 8 operations, or about 10 operations.

Optionally, in any embodiment, the second actuation number is from about 0.5 actuation to about 10 actuation. Optionally, in any embodiment, the second actuation number is at least about 0.5 actuation. Optionally, in any embodiment, the second actuation number is up to about 10 actuations. Optionally, in any embodiment, the second actuation number is from about 0.5 act to about 1 act, about 0.5 act to about 1.5 act, about 0.5 act to about 2 act, about 0. 5 operations to about 2.5 operations, about 0.5 operations to about 3 operations, about 0.5 operations to about 3.5 operations, about 0.5 operations to about 4 operations, about 0.5 operations to about 5 operations , About 0.5 operation to about 6 operation, about 0.5 operation to about 8 operation, about 0.5 operation to about 10 operation, about 1 operation to about 1.5 operation, about 1 operation to about 2 operation, about 1 operation to about 2.5 operation, about 1 operation to about 3 operation, about 1 operation to about 3.5 operation, about 1 operation to about 4 operation, about 1 operation to about 5 operation, about 1 operation to about 6 operation , About 1 operation to about 8 operations, about 1 operation to about 10 operations, about 1.5 operations to about 2 operations, about 1.5 operations to about 2.5 operations, about 1.5 operations to about 3 operations, about 1.5 operation to about 3.5 operation, about 1.5 operation to about 4 operation, about 1.5 operation to about 5 operation, about 1.5 operation to about 6 operation, about 1.5 operation to about 8 operation , About 1.5 operation to about 10 operation, about 2 operation to about 2.5 operation, about 2 operation to about 3 operation, about 2 operation to about 3.5 operation, about 2 operation to about 4 operation, about 2 operation ~ About 5 operations, about 2 operations ~ about 6 operations, about 2 operations ~ about 8 operations, about 2 operations ~ about 10 operations, about 2.5 operations ~ about 3 operations, about 2.5 operations ~ about 3.5 operations , About 2.5 operation to about 4 operation, about 2.5 operation to about 5 operation, about 2.5 operation to about 6 operation, about 2.5 operation to about 8 operation, about 2.5 operation to about 10 operation , About 3 operations to about 3.5 operations, about 3 operations to about 4 operations, about 3 operations to about 5 operations, about 3 operations to about 6 operations, about 3 operations to about 8 operations, about 3 operations to about 10 operations , About 3.5 operation to about 4 operation, about 3.5 operation to about 5 operation, about 3.5 operation to about 6 operation, about 3.5 operation to about 8 operation, about 3.5 operation to about 10 operation , About 4 to about 5 operations, about 4 to about 6 operations, about 4 to about 8 operations, about 4 to about 10 operations, about 5 to about 6 operations, about 5 to about 8 operations, about 5 operations to about 10 operations, about 6 operations to about 8 operations, about 6 operations to about 10 operations, or about 8 operations to about 10 operations. Optionally, in any embodiment, the second actuation number is about 0.5 actuation, about 1 actuation, about 1.5 actuation, about 2 actuation, about 2.5 actuation, about 3 actuation, about 3.5 actuation, About 4 operations, about 5 operations, about 6 operations, about 8 operations, or about 10 operations.

Optionally, in any embodiment, operating the drive mechanism in the first actuation direction by at least the first actuation number increases the height of the device by about 30% to about 400%. Optionally, in any embodiment, actuating the drive mechanism in the first actuation direction by at least the first actuation number increases the height of the device by at least about 30%. Optionally, in any embodiment, actuating the drive mechanism in the first actuation direction by at least the first actuation number increases the height of the device by up to about 400%. Optionally, in any embodiment, when the drive mechanism is actuated in the first actuation direction by at least the first actuation number, the height of the device is about 30% to about 50%, about 30% to about 75%. About 30% to about 100%, about 30% to about 125%, about 30% to about 150%, about 30% to about 175%, about 30% to about 200%, about 30% to about 250%, about 30 % To about 300%, about 30% to about 350%, about 30% to about 400%, about 50% to about 75%, about 50% to about 100%, about 50% to about 125%, about 50% to About 150%, about 50% to about 175%, about 50% to about 200%, about 50% to about 250%, about 50% to about 300%, about 50% to about 350%, about 50% to about 400 %, About 75% to about 100%, About 75% to about 125%, About 75% to about 150%, About 75% to about 175%, About 75% to about 200%, About 75% to about 250%, About 75% to about 300%, about 75% to about 350%, about 75% to about 400%, about 100% to about 125%, about 100% to about 150%, about 100% to about 175%, about 100 % To about 200%, about 100% to about 250%, about 100% to about 300%, about 100% to about 350%, about 100% to about 400%, about 125% to about 150%, about 125% to About 175%, about 125% to about 200%, about 125% to about 250%, about 125% to about 300%, about 125% to about 350%, about 125% to about 400%, about 150% to about 175 %, About 150% to about 200%, About 150% to about 250%, About 150% to about 300%, About 150% to about 350%, About 150% to about 400%, About 175% to about 200%, About 175% to about 250%, about 175% to about 300%, about 175% to about 350%, about 175% to about 400%, about 200% to about 250%, about 200% to about 300%, about 200 % To about 350%, about 200% to about 400%, about 250% to about 300%, about 250% to about 350%, about 250% to about 400%, about 300% to about 350%, about 300% to Increases by about 400%, or about 350% to about 400%. Optionally, in any embodiment, when the drive mechanism is actuated in the first actuation direction by at least the first actuation number, the height of the device is about 30%, about 50%, about 75%, about 100%, about. Increases by 125%, about 150%, about 175%, about 200%, about 250%, about 300%, about 350%, or about 400%.

Optionally, in any embodiment, actuating the drive mechanism in the first actuation direction by at least the first and second actuations increases the width of the device by about 14% to about 150%. Optionally, in any embodiment, actuating the drive mechanism in the first actuation direction by at least the first and second actuations increases the width of the device by at least about 14%. Optionally, in any embodiment, actuating the drive mechanism in the first actuation direction by at least the first and second actuations increases the width of the device by up to about 150%. Optionally, in any embodiment, when the drive mechanism is actuated in the first actuation direction by at least the first and second actuation numbers, the width of the device is about 14% to about 20%, about 14% to about 30%. , About 14% to about 40%, about 14% to about 50%, about 14% to about 60%, about 14% to about 70%, about 14% to about 80%, about 14% to about 90%, about 14% to about 100%, about 14% to about 120%, about 14% to about 150%, about 20% to about 30%, about 20% to about 40%, about 20% to about 50%, about 20% ~ About 60%, about 20% ~ about 70%, about 20% ~ about 80%, about 20% ~ about 90%, about 20% ~ about 100%, about 20% ~ about 120%, about 20% ~ about 150%, about 30% to about 40%, about 30% to about 50%, about 30% to about 60%, about 30% to about 70%, about 30% to about 80%, about 30% to about 90% , About 30% to about 100%, about 30% to about 120%, about 30% to about 150%, about 40% to about 50%, about 40% to about 60%, about 40% to about 70%, about 40% to about 80%, about 40% to about 90%, about 40% to about 100%, about 40% to about 120%, about 40% to about 150%, about 50% to about 60%, about 50% ~ About 70%, about 50% ~ about 80%, about 50% ~ about 90%, about 50% ~ about 100%, about 50% ~ about 120%, about 50% ~ about 150%, about 60% ~ about 70%, about 60% to about 80%, about 60% to about 90%, about 60% to about 100%, about 60% to about 120%, about 60% to about 150%, about 70% to about 80% , About 70% to about 90%, about 70% to about 100%, about 70% to about 120%, about 70% to about 150%, about 80% to about 90%, about 80% to about 100%, about 80% to about 120%, about 80% to about 150%, about 90% to about 100%, about 90% to about 120%, about 90% to about 150%, about 100% to about 120%, about 100% Increases by ~ about 150%, or about 120% to about 150%. Optionally, in any embodiment, when the drive mechanism is actuated in the first actuation direction by at least the first and second actuation numbers, the width of the device is about 14%, about 20%, about 30%, about 40. %, About 50%, about 60%, about 70%, about 80%, about 90%, about 100%, about 120%, or about 150% increase.

Optionally, in any embodiment, the actuator has a distal end and a proximal end.
Optionally, in any embodiment, at least a portion of the distal end comprises a first thread mechanism. Optionally, in any embodiment, at least a portion of the proximal end comprises a second thread mechanism, where the proximal end comprises a drive mechanism. Optionally, in any embodiment, at least one of the first thread mechanism and the second thread mechanism comprises a thread arranged outside the perimeter of the actuator. Optionally, in any embodiment, the first thread mechanism and the second thread mechanism have opposite threading directions.

Optionally, in any embodiment, the wedge assembly comprises a distal wedge and a proximal wedge. Optionally, in any embodiment, the actuation of the drive mechanism in the first direction brings the distal wedge and the proximal wedge closer to each other. Optionally, in any embodiment, the distal wedge comprises a third thread mechanism, the third thread mechanism being screwed into the first thread mechanism. Optionally, in any embodiment, the proximal wedge comprises a fourth thread mechanism, the fourth thread mechanism being liaisonably coupled to the second thread mechanism. Optionally, in any embodiment, the third thread mechanism comprises a thread located inside the distal wedge. Optionally, in any embodiment, the fourth thread mechanism comprises a thread located inside the proximal wedge.

Optionally, in any embodiment, the lamp assembly comprises a first distal lamp, a second distal lamp, a first proximal lamp, and a second proximal lamp. Optionally, in any embodiment, the slidable connection between the wedge assembly and the ramp assembly, the ramp assembly and the upper end plate assembly, and at least one of the ramp assembly and the lower end plate assembly is at an angular position across the vertical axis . .. Optionally, in any embodiment, the angle across the vertical axis is from about 0 ° to about 90 °. Optionally, in any embodiment, a slideable connection between the wedge assembly and the ramp assembly, the ramp assembly and the upper end plate assembly, and at least one of the ramp assembly and the lower end plate assembly comprises protrusions and slots. Optionally, in any embodiment, the protrusion extends from at least one of the wedge assembly, ramp assembly, upper end plate assembly and lower end plate assembly, and the slot is at least one of the upper end plate assembly and the lower end plate assembly. Placed in. Optionally, in any embodiment, the protrusions include pins, ridges, dimples, bolts, threads, bearings or any combination thereof. Optionally, in any embodiment, the slot comprises a through slot, a blind slot, a t-slot, a v-slot, a groove or any combination thereof.

Optionally, in any embodiment, the drive mechanism comprises a recessed area configured to receive the drive instrument. Optionally, in any embodiment, the recessed area is a slot, Philips, positive drive, flareson, Robertson, 12-point flange, hex socket, security hex socket, star drive, hexalove, security Torx®, ta, Includes three-point, three-wing, spanner head, clutch, one-way, double square, triple square, polydrive, spline drive, double hex, bristol, thread, friction fit, or pentalobe recess or any other shape recess. Optionally, in any embodiment, includes a protubalance configured to extend from the drive mechanism and be coupled to the drive instrument. Optionally, in any embodiment, the protubalance includes a hexagonal, hexarobula, threaded or square protubalance or any other form of protubalance.

Optionally, in any embodiment, the upper end plate assembly comprises a first end plate and a second end plate, and the lower end plate assembly comprises a third end plate and a fourth end plate. Optionally, in any embodiment, a first end plate and a second end plate, a third end plate and a fourth end plate, a first proximal lamp and a second proximal lamp, and a first. At least one of the distal ramp and the second distal ramp has mirror equivalence, optionally, in any embodiment, at least one of the second end plate and the fourth end plate is the first end plate and the third end plate. Greater than at least one of them. Optionally, in any embodiment, the outer surface of at least one of the first end plate, the second end plate, the third end plate and the fourth end plate comprises a texture configured to grip the vertebrae. .. Optionally, in any embodiment, the texture ring comprises teeth, ridges, rough surface areas, metal coatings, ceramic coatings, keels, spikes, protrusions, grooves or any combination thereof.

Optionally, in any embodiment, at least one of the actuator, wedge assembly, upper end plate assembly and lower end plate assembly is titanium, cobalt, stainless steel, tantalum, platinum, PEEK, PEKK, PEI, PET, carbon fiber, sulfuric acid. Includes barium, hydroxyapatite, ceramics, zirconium oxide, silicon nitride, carbon, bone implant pieces, desalted bone matrix products, synthetic bone substitutes, bone forming agents, bone growth-inducing materials or any combination thereof.

A third aspect provided herein is a method for implanting a deployable fusion device between two adjacent vertebrae: a device having a width and height between two adjacent vertebrae. To actuate the drive mechanism by the first actuation number in the first actuation to increase the width without increasing the height; and exceed the first actuation number in the first actuation direction. The device has width and height, including activating the drive mechanism by a second actuation number to increase at least one of height and width; and attaching an inserter to a deployable fusion device. This method is provided with a drive mechanism.

Optionally, in any embodiment, the actuation of the drive mechanism by a second actuation number exceeding the first actuation number in the first actuation direction increases both height and width. Optionally, in any embodiment, the actuation of the drive mechanism by a second actuation number exceeding the first actuation number in the first actuation direction increases the height without increasing the width.

Optionally, in any embodiment, the width of the device reaches the limit when the drive mechanism is actuated by at least the first actuation number. Optionally, in any embodiment, the height of the device reaches the limit when the drive mechanism is actuated by at least the first and second actuation numbers.

Optionally, in any embodiment, the first actuation number is from about 0.5 actuation to about 10 actuation. Optionally, in any embodiment, the first actuation number is at least about 0.5 actuation. Optionally, in any embodiment, the first actuation number is up to about 10 actuations. Optionally, in any embodiment, the first actuation number is from about 0.5 act to about 1 act, about 0.5 act to about 1.5 act, about 0.5 act to about 2 act, about 0. 5 operations to about 2.5 operations, about 0.5 operations to about 3 operations, about 0.5 operations to about 3.5 operations, about 0.5 operations to about 4 operations, about 0.5 operations to about 5 operations , About 0.5 operation to about 6 operation, about 0.5 operation to about 8 operation, about 0.5 operation to about 10 operation, about 1 operation to about 1.5 operation, about 1 operation to about 2 operation, about 1 operation to about 2.5 operation, about 1 operation to about 3 operation, about 1 operation to about 3.5 operation, about 1 operation to about 4 operation, about 1 operation to about 5 operation, about 1 operation to about 6 operation , About 1 operation to about 8 operations, about 1 operation to about 10 operations, about 1.5 operations to about 2 operations, about 1.5 operations to about 2.5 operations, about 1.5 operations to about 3 operations, about 1.5 operation to about 3.5 operation, about 1.5 operation to about 4 operation, about 1.5 operation to about 5 operation, about 1.5 operation to about 6 operation, about 1.5 operation to about 8 operation , About 1.5 operation to about 10 operation, about 2 operation to about 2.5 operation, about 2 operation to about 3 operation, about 2 operation to about 3.5 operation, about 2 operation to about 4 operation, about 2 operation ~ About 5 operations, about 2 operations ~ about 6 operations, about 2 operations ~ about 8 operations, about 2 operations ~ about 10 operations, about 2.5 operations ~ about 3 operations, about 2.5 operations ~ about 3.5 operations , About 2.5 operation to about 4 operation, about 2.5 operation to about 5 operation, about 2.5 operation to about 6 operation, about 2.5 operation to about 8 operation, about 2.5 operation to about 10 operation , About 3 operations to about 3.5 operations, about 3 operations to about 4 operations, about 3 operations to about 5 operations, about 3 operations to about 6 operations, about 3 operations to about 8 operations, about 3 operations to about 10 operations , About 3.5 operation to about 4 operation, about 3.5 operation to about 5 operation, about 3.5 operation to about 6 operation, about 3.5 operation to about 8 operation, about 3.5 operation to about 10 operation , About 4 to about 5 operations, about 4 to about 6 operations, about 4 to about 8 operations, about 4 to about 10 operations, about 5 to about 6 operations, about 5 to about 8 operations, about 5 operations to about 10 operations, about 6 operations to about 8 operations, about 6 operations to about 10 operations, or about 8 operations to about 10 operations. Optionally, in any embodiment, the first actuation number is about 0.5 actuation, about 1 actuation, about 1.5 actuation, about 2 actuation, about 2.5 actuation, about 3 actuation, about 3.5 actuation, About 4 operations, about 5 operations, about 6 operations, about 8 operations, or about 10 operations.

Optionally, in any embodiment, the second actuation number is from about 0.5 actuation to about 10 actuation. Optionally, in any embodiment, the second actuation number is at least about 0.5 actuation. Optionally, in any embodiment, the second actuation number is up to about 10 actuations. Optionally, in any embodiment, the second actuation number is from about 0.5 act to about 1 act, about 0.5 act to about 1.5 act, about 0.5 act to about 2 act, about 0. 5 operations to about 2.5 operations, about 0.5 operations to about 3 operations, about 0.5 operations to about 3.5 operations, about 0.5 operations to about 4 operations, about 0.5 operations to about 5 operations , About 0.5 operation to about 6 operation, about 0.5 operation to about 8 operation, about 0.5 operation to about 10 operation, about 1 operation to about 1.5 operation, about 1 operation to about 2 operation, about 1 operation to about 2.5 operation, about 1 operation to about 3 operation, about 1 operation to about 3.5 operation, about 1 operation to about 4 operation, about 1 operation to about 5 operation, about 1 operation to about 6 operation , About 1 operation to about 8 operations, about 1 operation to about 10 operations, about 1.5 operations to about 2 operations, about 1.5 operations to about 2.5 operations, about 1.5 operations to about 3 operations, about 1.5 operation to about 3.5 operation, about 1.5 operation to about 4 operation, about 1.5 operation to about 5 operation, about 1.5 operation to about 6 operation, about 1.5 operation to about 8 operation , About 1.5 operation to about 10 operation, about 2 operation to about 2.5 operation, about 2 operation to about 3 operation, about 2 operation to about 3.5 operation, about 2 operation to about 4 operation, about 2 operation ~ About 5 operations, about 2 operations ~ about 6 operations, about 2 operations ~ about 8 operations, about 2 operations ~ about 10 operations, about 2.5 operations ~ about 3 operations, about 2.5 operations ~ about 3.5 operations , About 2.5 operation to about 4 operation, about 2.5 operation to about 5 operation, about 2.5 operation to about 6 operation, about 2.5 operation to about 8 operation, about 2.5 operation to about 10 operation , About 3 operations to about 3.5 operations, about 3 operations to about 4 operations, about 3 operations to about 5 operations, about 3 operations to about 6 operations, about 3 operations to about 8 operations, about 3 operations to about 10 operations , About 3.5 operation to about 4 operation, about 3.5 operation to about 5 operation, about 3.5 operation to about 6 operation, about 3.5 operation to about 8 operation, about 3.5 operation to about 10 operation , About 4 to about 5 operations, about 4 to about 6 operations, about 4 to about 8 operations, about 4 to about 10 operations, about 5 to about 6 operations, about 5 to about 8 operations, about 5 operations to about 10 operations, about 6 operations to about 8 operations, about 6 operations to about 10 operations, or about 8 operations to about 10 operations. Optionally, in any embodiment, optionally, in any embodiment, the second actuation number is about 0.5 actuation, about 1 actuation, about 1.5 actuation, about 2 actuation, about 2.5 actuation, about 3. Operation, about 3.5 operation, about 4 operation, about 5 operation, about 6 operation, about 8 operation, or about 10 operation.

Optionally, in any embodiment, operating the drive mechanism in the first actuation direction by at least the first actuation number increases the height of the device by about 30% to about 400%. Optionally, in any embodiment, actuating the drive mechanism in the first actuation direction by at least the first actuation number increases the height of the device by at least about 30%. Optionally, in any embodiment, actuating the drive mechanism in the first actuation direction by at least the first actuation number increases the height of the device by up to about 400%. Optionally, in any embodiment, when the drive mechanism is actuated in the first actuation direction by at least the first actuation number, the height of the device is about 30% to about 50%, about 30% to about 75%, about. 30% to about 100%, about 30% to about 125%, about 30% to about 150%, about 30% to about 175%, about 30% to about 200%, about 30% to about 250%, about 30% ~ About 300%, about 30% ~ about 350%, about 30% ~ about 400%, about 50% ~ about 75%, about 50% ~ about 100%, about 50% ~ about 125%, about 50% ~ about 150%, about 50% to about 175%, about 50% to about 200%, about 50% to about 250%, about 50% to about 300%, about 50% to about 350%, about 50% to about 400% , About 75% to about 100%, about 75% to about 125%, about 75% to about 150%, about 75% to about 175%, about 75% to about 200%, about 75% to about 250%, about 75% to about 300%, about 75% to about 350%, about 75% to about 400%, about 100% to about 125%, about 100% to about 150%, about 100% to about 175%, about 100% ~ About 200%, about 100% ~ about 250%, about 100% ~ about 300%, about 100% ~ about 350%, about 100% ~ about 400%, about 125% ~ about 150%, about 125% ~ about 175%, about 125% to about 200%, about 125% to about 250%, about 125% to about 300%, about 125% to about 350%, about 125% to about 400%, about 150% to about 175% , About 150% to about 200%, about 150% to about 250%, about 150% to about 300%, about 150% to about 350%, about 150% to about 400%, about 175% to about 200%, about 175% to about 250%, about 175% to about 300%, about 175% to about 350%, about 175% to about 400%, about 200% to about 250%, about 200% to about 300%, about 200% ~ About 350%, about 200% ~ about 400%, about 250% ~ about 300%, about 250% ~ about 350%, about 250% ~ about 400%, about 300% ~ about 350%, about 300% ~ about Increases by 400%, or about 350% to about 400%. Optionally, in any embodiment, when the drive mechanism is actuated in the first actuation direction by at least the first actuation number, the height of the device is about 30%, about 50%, about 75%, about 100%, about. Increases by 125%, about 150%, about 175%, about 200%, about 250%, about 300%, about 350%, or about 400%.

Optionally, in any embodiment, actuating the drive mechanism in the first actuation direction by at least the first and second actuations increases the width of the device by about 14% to about 150%. Optionally, in any embodiment, actuating the drive mechanism in the first actuation direction by at least the first and second actuations increases the width of the device by at least about 14%. Optionally, in any embodiment, actuating the drive mechanism in the first actuation direction by at least the first and second actuations increases the width of the device by up to about 150%. Optionally, in any embodiment, when the drive mechanism is actuated in the first actuation direction by at least the first and second actuation numbers, the width of the device is about 14% to about 20%, about 14% to about 30. %, About 14% to about 40%, about 14% to about 50%, about 14% to about 60%, about 14% to about 70%, about 14% to about 80%, about 14% to about 100%, About 14% to about 120%, about 14% to about 140%, about 14% to about 150%, about 20% to about 30%, about 20% to about 40%, about 20% to about 50%, about 20 % To about 60%, about 20% to about 70%, about 20% to about 80%, about 20% to about 100%, about 20% to about 120%, about 20% to about 140%, about 20% to About 150%, about 30% to about 40%, about 30% to about 50%, about 30% to about 60%, about 30% to about 70%, about 30% to about 80%, about 30% to about 100 %, About 30% to about 120%, about 30% to about 140%, about 30% to about 150%, about 40% to about 50%, about 40% to about 60%, about 40% to about 70%, About 40% to about 80%, about 40% to about 100%, about 40% to about 120%, about 40% to about 140%, about 40% to about 150%, about 50% to about 60%, about 50 % To about 70%, about 50% to about 80%, about 50% to about 100%, about 50% to about 120%, about 50% to about 140%, about 50% to about 150%, about 60% to About 70%, about 60% to about 80%, about 60% to about 100%, about 60% to about 120%, about 60% to about 140%, about 60% to about 150%, about 70% to about 80 %, About 70% to about 100%, About 70% to about 120%, About 70% to about 140%, About 70% to about 150%, About 80% to about 100%, About 80% to about 120%, About 80% to about 140%, about 80% to about 150%, about 100% to about 120%, about 100% to about 140%, about 100% to about 150%, about 120% to about 140%, about 120 % To about 150%, or about 140% to about 150% increase.
Optionally, in any embodiment, when the drive mechanism is actuated in the first actuation direction by at least the first and second actuation numbers, the width of the device is about 14%, about 20%, about 30%, about 40. %, About 50%, about 60%, about 70%, about 80%, about 100%, about 120%, about 140%, or about 150% increase.

Optionally, in any embodiment, the actuator has a distal end and a proximal end.
Optionally, in any embodiment, at least a portion of the distal end comprises a first thread mechanism. Optionally, in any embodiment, at least a portion of the proximal end comprises a second thread mechanism, where the proximal end comprises a drive mechanism. Optionally, in any embodiment, at least one of the first thread mechanism and the second thread mechanism comprises a thread arranged outside the perimeter of the actuator. Optionally, in any embodiment, the first thread mechanism and the second thread mechanism have opposite threading directions.

Optionally, in any embodiment, the wedge assembly comprises a distal wedge and a proximal wedge. Optionally, in any embodiment, the actuation of the drive mechanism in the first direction brings the distal wedge and the proximal wedge closer to each other. Optionally, in any embodiment, the distal wedge comprises a third thread mechanism, the third thread mechanism being screwed into the first thread mechanism. Optionally, in any embodiment, the proximal wedge comprises a fourth thread mechanism, the fourth thread mechanism being screwed into a second thread mechanism. Optionally, in any embodiment, the third thread mechanism comprises a thread located inside the distal wedge. Optionally, in any embodiment, the fourth thread mechanism comprises a thread located inside the proximal wedge.

Optionally, in any embodiment, the lamp assembly comprises a first distal lamp, a second distal lamp, a first proximal lamp, and a second proximal lamp. Optionally, in any embodiment, the slidable connection between the wedge assembly and the ramp assembly, the ramp assembly and the upper end plate assembly, and at least one of the ramp assembly and the lower end plate assembly is at an angular position across the vertical axis . .. Optionally, in any embodiment, the angle across the vertical axis is from about 30 ° to about 90 °. Optionally, in any embodiment, a slideable connection between the wedge assembly and the ramp assembly, the ramp assembly and the upper end plate assembly, and at least one of the ramp assembly and the lower end plate assembly comprises protrusions and slots. Optionally, in any embodiment, the protrusion extends from at least one of the wedge assembly, ramp assembly, upper end plate assembly and lower end plate assembly, and the slot is at least one of the upper end plate assembly and the lower end plate assembly. Placed in. Optionally, in any embodiment, the protrusions include pins, ridges, dimples, bolts, threads, bearings or any combination thereof. Optionally, in any embodiment, the slot comprises a through slot, a blind slot, a t-slot, a v-slot, a groove or any combination thereof.

Optionally, in any embodiment, the drive mechanism comprises a recessed area configured to receive the drive instrument. Optionally, in any embodiment, the recessed area is a slot, Philips, positive drive, flareson, Robertson, 12-point flange, hex socket, security hex socket, star drive, security Torx®, ta, three points. Includes, three wings, spanner head, clutch, one way, double square, triple square, polydrive, spline drive, double hex, bristol, thread, friction fit, or pentalobe recess. Optionally, in any embodiment, includes a protubalance configured to extend from the drive mechanism and be coupled to the drive instrument. Optionally, in any embodiment, the protubalance comprises a hexagonal, hexarobula, threaded or square protubalance.

Optionally, in any embodiment, the upper end plate assembly comprises a first end plate and a second end plate, and the lower end plate assembly comprises a third end plate and a fourth end plate. Optionally, in any embodiment, a first end plate and a second end plate, a third end plate and a fourth end plate, a first proximal lamp and a second proximal lamp, and a first. At least one of the distal ramp and the second distal ramp has mirror equivalence, optionally, in any embodiment, at least one of the second end plate and the fourth end plate is the first end plate and the third end plate. Greater than at least one of them. Optionally, in any embodiment, the outer surface of at least one of the first end plate, the second end plate, the third end plate and the fourth end plate comprises a texture configured to grip the vertebrae. .. Optionally, in any embodiment, the texture ring comprises teeth, ridges, rough surface areas, metal coatings, ceramic coatings, keels, spikes, protrusions, grooves or any combination thereof.

Optionally, in any embodiment, at least one of the actuator, wedge assembly, upper end plate assembly and lower end plate assembly is titanium, cobalt, stainless steel, tantalum, platinum, PEEK, PEKK, carbon fiber, barium sulfate, hydroxyapatite. Includes ceramic, zirconium oxide, silicon nitride, carbon, bone implant pieces, desalted bone matrix products, synthetic bone substitutes, bone forming agents, bone growth-inducing materials or any combination thereof.

Further application areas of this disclosure will become apparent from the detailed description provided below. It is understood that the detailed description and specific examples show preferred or exemplary embodiments of the present disclosure, but are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure. It should be.

The novel features of this disclosure are described in detail in the appended claims. A better understanding of the features and benefits of the present disclosure will be obtained by reference to the following detailed description, and the accompanying drawings, illustrating exemplary embodiments in which the principles of the present disclosure are utilized:

FIG. 1 shows an exemplary first deployable fusion device implanted between two vertebral bodies in the initial folded state.

FIG. 2 shows an exemplary first deployable fusion device implanted between two vertebral bodies in a fully deployed state.

FIG. 3 shows a perspective view of an exemplary first deployable fusion device in the initial folded state.

FIG. 4 shows a perspective view of an exemplary first deployable fusion device in a fully deployed state.

FIG. 5 shows a three-dimensional exploded view of an exemplary first deployable fusion device.

FIG. 6A shows a plan top view of an exemplary first deployable fusion device in its initial folded state.

FIG. 6B shows a plan end view of an exemplary first deployable fusion device in its initial folded state.

FIG. 6C shows a plan top view of an exemplary first deployable fusion device with the width fully deployed.

FIG. 6D shows a planar end-view of an exemplary first deployable fusion device with a fully unfolded width.

FIG. 6E shows a plan top view of an exemplary first deployable fusion device in which both width and height are fully deployed.

FIG. 6F shows a plan end view of an exemplary first deployable fusion device in a fully deployed state, both in width and height.

FIG. 7A shows a detailed view of an exemplary first deployable fusion device in the initial folded state, exemplifying a joint that causes a delay in height deployment.

FIG. 7B shows a detailed view of an exemplary first deployable fusion device, particularly in the deployed state.

FIG. 7C shows a detailed view of an exemplary first deployable fusion device, particularly in the unfolded state in width and height.

FIG. 8A shows a bottom view of an exemplary end plate.

FIG. 8B shows a top view of an exemplary end plate.

FIG. 9A shows an exemplary end plate with a T-shaped slot.

FIG. 9B shows an exemplary end plate with an L-shaped slot.

FIG. 9C shows an exemplary end plate with a Y-shaped slot.

FIG. 9D shows an exemplary end plate with an F-shaped slot.

FIG. 9E shows an exemplary end plate with linear slots.

FIG. 10A shows a perspective top view of an exemplary end plate.

FIG. 10B shows a bottom view of an exemplary end plate.

FIG. 10C shows a perspective view of an exemplary first deployable fusion device in a fully deployed state.

FIG. 10D1 shows a perspective view of an exemplary first deployable fusion device in the initial folded state.

FIG. 10D2 shows a perspective view of an exemplary first deployable fusion device in a fully deployed state.

FIG. 10D3 shows a perspective view of an exemplary first deployable fusion device in a fully deployed state with bone fasteners assembled.

FIG. 11A shows an end view of an exemplary first deployable fusion device, all equipped with a planar end plate.

FIG. 11B shows an end view of an exemplary first deployable fusion device with an entirely convex end plate.

FIG. 11C shows an end view of an exemplary first deployable fusion device, all individually provided with convex end plates.

FIG. 11D shows an end view of an exemplary first deployable fusion device with all flat end plates, with some end plates having different heights.

FIG. 11E shows an end view of an exemplary first deployable fusion device in which the top and bottom plates are substantially convex and lordotic.

FIG. 11F shows an end view of an exemplary first deployable fusion device, all comprising convex end plates, with several end plates having different heights.

FIG. 11G shows an end view of an exemplary first deployable fusion device with flat and lordotic end plates.

FIG. 11H shows an end view of an exemplary first deployable fusion device with a flat bottom-end plate and a top-end plate with individually convex different nagawa.

FIG. 11I shows an end view of an exemplary first deployable fusion device with two substantially convex top-end plates and two flat bottom-end plates.

FIG. 12A shows a side view of an exemplary first deployable fusion device, all equipped with a planar end plate.

FIG. 12B shows a side view of an exemplary first deployable fusion device, all with dome-shaped end plates.

FIG. 12C shows a side view of an exemplary first deployable fusion device, all with planar and slanted end plates.

FIG. 12D shows an end view of an exemplary first deployable fusion device, all with planar and dome-shaped end plates.

FIG. 13A shows a top view of an exemplary first deployable fusion device with all end plates of the same length in the initial folded state.

FIG. 13B shows a top view of an exemplary first deployable fusion device with different lengths of end plates in the initial folded state.

FIG. 13C shows a top view of an exemplary first deployable fusion device with all end plates of the same length in the fully unfolded state.

FIG. 13D shows a top view of an exemplary first deployable fusion device with different lengths of end plates in a fully unfolded state.

FIG. 14A shows a side view of the height deployment of an exemplary first deployable fusion device.

FIG. 14B1 shows a top view of the folded state of an exemplary first deployable fusion device configured so that both ends are non-uniformly unfolded.

FIG. 14B2 shows a top view of a fully unfolded state of an exemplary first deployable fusion device, provided with an alternative unfolding mechanism and designed to unfold at both ends non-uniformly.

FIG. 15A shows a side view of the width deployment of an exemplary first deployable fusion device.

FIG. 15B is a top view of an exemplary first deployable fusion device with different lengths of end plates designed to be wider on one side than on the other. show.

FIG. 15C shows the full width of an exemplary first deployable fusion device with different lengths of end plates designed to expand more on one side than on the other. Shows a top view of the unfolded state.

FIG. 15D shows the fully unfolded exemplary first deployable fusion device with different lengths of end plates designed to be wider on one side than on the other. The perspective view of the state is shown.

FIG. 15E shows a perspective view of an exemplary distal wedge with a non-uniform lamp.

FIG. 15F shows a perspective view of an exemplary proximal wedge with a non-uniform lamp.

FIG. 15G shows a perspective view of an exemplary lamp.

FIG. 16 shows an end view of the height deployment of an exemplary first deployable fusion device.

FIG. 17A shows an exemplary lamp internal perspective view.

FIG. 17B shows an exemplary lamp outside perspective.

FIG. 18A shows an inside perspective of an exemplary lamp with an L-shaped branch.

FIG. 18B shows an inside perspective of an exemplary lamp with a C-shaped branch.

FIG. 18C shows an inside perspective of an exemplary lamp with a T-shaped branch and a T-shaped channel.

FIG. 18D shows an inside perspective of an exemplary lamp with a Y-shaped branch and a Y-shaped channel.

FIG. 18E shows an inside perspective of an exemplary lamp with an inner T-shaped branch and a Y-shaped channel.

FIG. 19A shows an inside perspective view of an exemplary lamp having a cylindrical branch with a linear cross section.

FIG. 19B shows an outside perspective of an exemplary lamp having a cylindrical branch with a linear cross section.

FIG. 19C shows an inside perspective view of an exemplary lamp having a cylindrical branch with an L-shaped cross section.

FIG. 19D shows an outside perspective view of an exemplary lamp having a cylindrical branch with an L-shaped cross section.

FIG. 19E shows an inside perspective view of an exemplary lamp having a cylindrical branch with a T-shaped cross section.

FIG. 19F shows an outside perspective view of an exemplary lamp having a cylindrical branch with a T-shaped cross section.

FIG. 19G1 shows a detailed cross-sectional view of the articulation between an exemplary ramp and an exemplary end plate in the unassembled state.

FIG. 19G2 shows a detailed cross-sectional view of the articulation between an exemplary ramp and an exemplary end plate in a partially assembled state.

FIG. 19G3 shows a detailed cross-sectional view of the articulation between an exemplary ramp and an exemplary end plate in a fully assembled state with a limited range of movement of the ramp.

FIG. 19H1 shows a detailed cross-sectional view of the articulation between a exemplary ramp, an exemplary end plate, and an exemplary fastener, where the range of movement of the ramp is limited.

FIG. 19H2 shows a detailed three-dimensional exploded view of the articulation between an exemplary ramp, an exemplary end plate, and an exemplary fastener, where the range of movement of the ramp is limited.

FIG. 20 shows a perspective view of an exemplary actuator aspect.

FIG. 21A shows a perspective view of an exemplary actuator.

FIG. 21B shows a perspective view of an exemplary actuator.

FIG. 22 shows an exemplary holding pin perspective view.

FIG. 23 shows a perspective view of an exemplary holding set screw.

FIG. 24 shows a perspective view of an exemplary holding c-clip.

FIG. 25 shows a cross-sectional view of the articulation between an exemplary proximal wedge, an exemplary actuator, and an exemplary holding c-clip.

FIG. 26A shows a rear perspective view of an exemplary proximal wedge.

FIG. 26B shows a front perspective view of an exemplary proximal wedge.

FIG. 27A shows a perspective view of an exemplary proximal wedge with a T-shaped protrusion.

FIG. 27B shows a perspective view of an exemplary proximal wedge with a threaded central opening and an alternative instrument attachment mechanism.

FIG. 27C shows a perspective view of an exemplary proximal wedge with a T-shaped protrusion and an alternative instrument attachment mechanism.

FIG. 27D shows a perspective view of an exemplary proximal wedge with a T-shaped protrusion, an alternative instrument attachment mechanism, and an alternative side opening shape.

FIG. 28A shows an exemplary distal wedge front perspective view.

FIG. 28B shows a front perspective view of an exemplary distal wedge with a T-shaped protrusion and no side openings.

FIG. 29A shows a front perspective view of an exemplary distal wedge with a T-shaped protrusion.

FIG. 29B shows a front perspective view of an exemplary distal wedge with a T-shaped protrusion and no side openings.

FIG. 30 shows a perspective view of an exemplary insertion instrument.

FIG. 31 shows a perspective view of an exemplary insertion instrument.

FIG. 32 shows a detailed perspective view of the distal end of an exemplary insertion instrument.

FIG. 33 shows a perspective view of an exemplary deployment drive instrument.

FIG. 34 shows a perspective view of an exemplary first deployable fusion device attached to an exemplary inserter.

FIG. 35 shows an exemplary first deployable fusion device fitted with an exemplary inserter, in an initially folded state, implanted between two vertebral bodies.

FIG. 36 shows a perspective view of an exemplary first deployable fusion device attached to an exemplary inserter with an exemplary deployable drive instrument.

FIG. 37 shows a detailed perspective view of an exemplary first deployable fusion device attached to an exemplary inserter.

FIG. 38 shows a detailed perspective view of an exemplary first deployable fusion device, partially expanded, attached to an exemplary inserter.

FIG. 39 is a detailed perspective view of an exemplary first deployable fusion device in a fully unfolded state attached to an exemplary inserter.

FIG. 40 shows a detailed perspective view of an exemplary first deployable fusion device attached to an exemplary inserter, fully width and height deployed.

FIG. 41 shows a perspective view of an exemplary first deployable fusion device in a fully width and height unfolded state, filled with graft material and attached to an exemplary inserter.

FIG. 42 shows an exemplary first deployable fusion device that is implanted between two vertebral bodies in a fully deployed state and filled with graft material.

FIG. 43 shows an exemplary insertion instrument.

FIG. 44 shows a detailed cross-sectional view of an exemplary actuation mechanism of an exemplary insertion instrument.

FIG. 45 shows a detailed view of the distal end of the main shaft of an exemplary insertion instrument.

FIG. 46 shows a detailed view of the distal end of an exemplary insertion instrument.

FIG. 47 shows a detailed cross-sectional view of the articulation between the exemplary first deployable fusion device and the exemplary inserter.

FIG. 48 shows a detailed perspective view of an exemplary first deployable fusion device in an early folded state attached to an exemplary inserter in the unlocked state.

FIG. 49 shows a detailed perspective view of an exemplary first deployable fusion device attached to an exemplary inserter in the locked state, in the initial folded state.

FIG. 50 shows a perspective view of an exemplary first deployable fusion device attached to an exemplary inserter, including an exemplary deployable drive instrument.

FIG. 51 shows a perspective view of an exemplary first deployable fusion device attached to an exemplary inserter in a fully width unfolded state.

FIG. 52 shows a perspective view of an exemplary first deployable fusion device in full width and height unfolded state and attached to an exemplary inserter.

FIG. 53 shows a perspective view of an exemplary first deployable fusion device in a fully width and height unfolded state, filled with graft material and attached to an exemplary inserter.

FIG. 54A shows a perspective view of an exemplary second deployable fusion device in the initial folded state.

FIG. 54B shows a perspective view of an exemplary second deployable fusion device of FIG. 54A in a fully deployed state.

FIG. 54C shows a three-dimensional exploded view of an exemplary second deployable fusion device.

FIG. 55A shows a front view of an exemplary proximal wedge used in the exemplary second deployable fusion device of FIGS. 54A-54C.

FIG. 55B shows a rear view of an exemplary proximal wedge used in the exemplary second deployable fusion device of FIGS. 54A-54C.

FIG. 56A shows a perspective view of an exemplary third deployable fusion device in the initial folded state.

FIG. 56B shows an exemplary third deployable fusion perspective in a fully deployed state.

FIG. 56C shows a three-dimensional exploded view of an exemplary third deployable fusion device.

FIG. 57A shows a right side view of an exemplary lamp of an exemplary third deployable fusion device.

FIG. 57B shows a left side view of an exemplary lamp of an exemplary third deployable fusion device.

FIG. 58 shows a bottom view of an exemplary end plate of an exemplary third deployable fusion device.

FIG. 59A shows a perspective view of an exemplary fourth deployable fusion device in the initial folded state.

FIG. 59B shows a perspective view of an exemplary fourth deployable fusion device of FIG. 59A in a fully deployed state.

FIG. 59C shows a top view of an exemplary fourth deployable fusion device of FIG. 59A in the initial fully folded state.

FIG. 59D shows a perspective view of a partial assembly of an exemplary fourth deployable fusion device, including two opposing end plates.

FIG. 60A shows a perspective view of an exemplary fifth deployable fusion device in a fully deployed state.

FIG. 60B shows a side view of an exemplary fifth deployable fusion device of FIG. 60A in a fully deployed state.

FIG. 61A shows a perspective view of an exemplary sixth deployable fusion device in a fully deployed state.

FIG. 61B shows a three-dimensional exploded view of an exemplary sixth deployable fusion device.

FIG. 62A shows a perspective view of an exemplary seventh deployable fusion device in a fully deployed state.

FIG. 62B shows a three-dimensional exploded view of an exemplary seventh deployable fusion device.

FIG. 63A shows a perspective view of an exemplary eighth deployable fusion device in the initial folded state.

FIG. 63B shows a perspective view of an exemplary eighth deployable fusion device in a fully width-deployed state.

FIG. 63C shows a perspective view of an exemplary eighth deployable fusion device in a fully deployed state.

FIG. 63D shows an exemplary eighth expandable fusion three-dimensional exploded view.

FIG. 64 shows a perspective view of an exemplary eighth proximal wedge used in an exemplary deployable fusion device.

FIG. 65A shows a perspective view of an exemplary ninth deployable fusion device in the initial folded state.

FIG. 65B shows a perspective view of an exemplary ninth deployable fusion device in a fully deployed state.

FIG. 65C shows a partially assembled perspective view of an exemplary ninth deployable fusion device in its initial folded state.

FIG. 65D shows a partially assembled perspective view of an exemplary ninth expandable fusion device in a partially expanded state (linear width expansion only).

FIG. 65E shows a partially assembled perspective view of an exemplary ninth deployable fusion device in a fully width unfolded state (both linear and angular unfolded completed).

FIG. 66A shows a perspective view of an exemplary tenth deployable fusion device in a fully deployed state.

FIG. 66B shows a perspective view of an exemplary tenth deployable fusion device in the initial folded state.

FIG. 66C shows a perspective view of an exemplary tenth deployable fusion device in a fully unfolded state.

FIG. 66D shows a top perspective view of an exemplary tenth compound end plate used in an exemplary deployable fusion device.

FIG. 67A shows a perspective view of an exemplary eleventh deployable fusion device in a fully deployed state.

FIG. 67B shows a perspective view of an exemplary eleventh end plate duplex used in an exemplary deployable fusion device.

FIG. 67C shows a perspective view of an exemplary eleventh deployable fusion device of FIG. 67A in the initial folded state.

FIG. 67D shows a perspective view of an exemplary eleventh deployable fusion device of FIG. 67A in a fully widened state.

FIG. 68 shows a perspective view of an exemplary twelfth deployable fusion device in the initial folded state.

FIG. 69A shows a rear perspective view of an exemplary twelfth proximal wedge used in an exemplary deployable fusion device.

FIG. 69B shows a cross-sectional view of an exemplary twelfth proximal wedge used in an exemplary deployable fusion device.

FIG. 70A shows a front view of an exemplary twelfth distal wedge used in an exemplary deployable fusion device.

FIG. 70B shows a cross-sectional view of an exemplary twelfth distal wedge used in an exemplary deployable fusion device.

FIG. 71 shows a perspective view of an exemplary twelfth deployable fusion device, in the initial folded state and assembled with a tensioning instrument.

FIG. 72A shows a cross-sectional view of an exemplary twelfth deployable fusion device in the initial folded state assembled with a tensioning instrument.

FIG. 72B shows a cross-sectional view of an exemplary twelfth deployable fusion device in unfolded state assembled by a tensioning instrument.

FIG. 72C shows a cross-sectional view of an exemplary twelfth deployable fusion device in a deployed state with a tension member locked in place.

FIG. 73A shows a top view of an exemplary thirteen deployable fusion device in the initial folded state.

FIG. 73B shows a top view of an exemplary thirteenth exemplary deployable fusion device in a fully width-deployed state.

FIG. 73C shows a perspective view of an exemplary thirteen deployable fusion device in a fully height-deployed state.

FIG. 73D shows a three-dimensional exploded view of an exemplary thirteen deployable fusion device.

FIG. 74A shows a perspective view of an exemplary thirteen expandable fusion device attached to an exemplary insert-deployer in the initial folded state.

FIG. 74B shows a perspective view of an exemplary thirteen expandable fusion device attached to an exemplary insert-deploy instrument in a fully wide unfolded state.

FIG. 75A shows a top view of an exemplary 14 deployable fusion device in the initial folded state.

FIG. 75B shows a top view of an exemplary 14 deployable fusion device in a fully unfolded state.

FIG. 75C shows a perspective view of an exemplary 14 deployable fusion device in a fully height-deployed state.

FIG. 75D shows a perspective view of an exemplary 14 deployable fusion device in a fully width and height unfolded state.

FIG. 75E shows a three-dimensional exploded view of an exemplary 14 deployable fusion device.

FIG. 76A shows a top view of an exemplary fifteenth deployable fusion device in the initial folded state.

FIG. 76B shows a top view of an exemplary fifteenth deployable fusion device in a fully width-deployed state.

FIG. 76C shows a perspective view of an exemplary fifteen deployable fusion device in a fully width and height unfolded state.

FIG. 76D shows a three-dimensional exploded view of an exemplary fifteenth deployable fusion device.

FIG. 77A shows a perspective view of an exemplary fifteenth deployable fusion device attached to an insertion-deployment instrument in its initial folded state.

FIG. 77B shows a perspective view of an exemplary fifteenth deployable fusion device attached to an insert-deploy instrument in a fully width-deployed state.

FIG. 78 shows a perspective view of an exemplary 16 deployable fusion device in the initial folded state.

FIG. 79A shows a perspective view of an exemplary 16 deployable fusion device attached to an insertion-deployment instrument in its initial folded state.

FIG. 79B shows a perspective view of an exemplary 16 deployable fusion device attached to an insert-deploy instrument in a fully width-deployed state.

FIG. 80 shows a schematic top view of an exemplary 17th deployable fusion device outlining its initial width-expanded configuration.

FIG. 81A shows a perspective view of an exemplary 18 deployable fusion device in its unfolded state.

FIG. 81B shows a perspective view of an exemplary 18 deployable fusion device in its folded state.

FIG. 81C shows a perspective view of an exemplary 18 deployable fusion device in a disassembled state.

FIG. 82 shows a perspective view of an exemplary actuator of the eighteenth deployable fusion device.

FIG. 83A shows a perspective view of an exemplary proximal wedge of the 18th deployable fusion device.

FIG. 83B shows a perspective view of an exemplary distal wedge of the 18th deployable fusion device.

FIG. 84A shows a first perspective view of an exemplary proximal lamp of the 18th deployable fusion device.

FIG. 84B shows a second perspective view of an exemplary proximal lamp of the 18th deployable fusion device.

FIG. 85 shows a perspective view of an exemplary distal lamp of the 18th deployable fusion device.

FIG. 86 shows a perspective view of an exemplary end plate of the 18th deployable fusion device.

FIG. 87A shows a perspective view of an exemplary 19th deployable fusion device in its unfolded state.

FIG. 87B shows a perspective view of an exemplary 19 deployable fusion device in its folded state.

FIG. 87C shows a perspective view of an exemplary 19 deployable fusion device in the disassembled state.

FIG. 88 shows a perspective view of an exemplary actuator of the 19th deployable fusion device.

FIG. 89A shows a perspective view of an exemplary distal wedge of an exemplary 19 deployable fusion device.

FIG. 89B shows a perspective view of an exemplary distal wedge of an exemplary 19th deployable fusion device.

FIG. 90A shows a perspective view of an exemplary first lamp of an exemplary 19 deployable fusion device.

FIG. 90B shows a perspective view of an exemplary first lamp of an exemplary 19 deployable fusion device.

FIG. 91A shows a perspective view of an exemplary second lamp of an exemplary 19 deployable fusion device.

FIG. 91B shows a perspective view of an exemplary second lamp of an exemplary 19 deployable fusion device.

FIG. 92A shows a perspective view of an exemplary first end plate of an exemplary 19 deployable fusion device.

FIG. 92B shows a perspective view of an exemplary first end plate of an exemplary 19 deployable fusion device.

FIG. 93A shows a perspective view of an exemplary second end plate of an exemplary 19 deployable fusion device.

FIG. 93B shows a perspective view of an exemplary second end plate of an exemplary 19 deployable fusion device.

FIG. 94A shows a perspective view of an exemplary third end plate of an exemplary 19 deployable fusion device.

FIG. 94B shows a perspective view of an exemplary third end plate of an exemplary 19 deployable fusion device.

FIG. 95A shows a perspective view of an exemplary fourth end plate of an exemplary 19 deployable fusion device.

FIG. 95B shows a perspective view of an exemplary fourth end plate of an exemplary 19 deployable fusion device.

FIG. 96A shows a perspective view of an exemplary 19 deployable fusion device and an exemplary separate inserter tool.

FIG. 96B shows a perspective view of an exemplary 19 deployable fusion device and an exemplary connection inserter tool.

FIG. 97 shows a cross-sectional view of an exemplary 19 deployable fusion device and an exemplary connection inserter tool.

FIG. 98A shows a perspective view of an exemplary twentieth deployable fusion device in its folded state.

FIG. 98B shows a perspective view of an exemplary twentieth deployable fusion device in the disassembled state.

FIG. 99 shows a top view of an exemplary 21 deployable fusion device.

Detailed Description The following description of the various embodiments is merely exemplary in nature and is by no means intended to limit the teaching, their application or use. The following description is generally directed to aspects of deployable fusion devices and methods for their implantation between two adjacent lumbar vertebrae into the spine using the lateral, posterior and transvertebral foramen approaches. On the other hand, similar mechanisms and arrangements thereof utilize other surgical approaches, including but not limited to vertebral arch, transiliac, anterior and anterior-lateral approaches, to the neck, chest, etc. It will also be used in the treatment of the spinal segment and will be understood to be configured to interlock each anatomy and approach angle. Similarly, the following description is generally directed to the embodiment of a deployable fusion device in which the actuator pulls the wedge together to cause deployment, while in other embodiments, the actuator forcibly pulls the wedge apart. It will be understood that the same functionality can be easily achieved. Spinal fusion is typically employed to relieve pain caused by the movement of degenerated disc materials. Upon successful fusion, the fusion device is permanently anchored in the disc space.

First deployable fusion device The first deployable fusion device in the initial folded state implanted between the end plates 6 and 8 of adjacent vertebral bodies 2 and 4 via the surgical corridor 5. An exemplary embodiment of 1000 is shown in FIG. Implantation of the first deployable fusion device 1000 in the initial folded state can reduce the size of the fitting input and surgical corridor 5 required for implantation. As shown in FIG. 2, a first deployable fusion device 1000 is implanted between adjacent vertebral bodies 2 and 4 via a surgical corridor 5 and deployed to engage end plates 6 and 8 (as shown in FIG. 2). Shown in the unfolded state) in both width and height. The first deployable fusion device 1000 is from about 8 mm to about 13 mm in height, or more preferably from 8 mm to 16 mm, or most preferably from 7 mm to 14 mm, and in width from about 10 mm to about 18 mm. , And more preferably from about 11 mm to about 20 mm, and more preferably from about 14 mm to about 24 mm, or most preferably from about 15 mm to about 26 mm. The first deployable fusion device 1000 is preferably longer than its width in its initial folded state, and the end plates are preferably longer than their width. Deploying the healing device 1000 while being implanted between the vertebral bodies 2 and 4 is the width of the healing device 1000, as well as the spacing or contact between the healing device 1000 and the end plates 6 and 8 beyond it. Allows an increase in area (or footprint), which is otherwise preferably with the vertebral bodies 2 and 4 by increasing and maintaining the height of the implant and / or the angular orientation of its components. To increase and maintain the distance and / or angle between them, it will be tolerated by the application of extension forces to the surgical corridor 5, as well as the end plates 6 and 8.

The components of the first deployable Fusing Device 1000 include, but are not limited to, metals and alloys (eg, chemically pure titanium, titanium alloys including Ti-6Al-4V base alloys, CoCrMo alloys). Carbon fiber reinforced varieties, including cobalt alloys, stainless steel, tantalum and its alloys, platinum and its alloys, etc., polymers (eg, for example, carbon fiber, carbon nanotubes, graphene, barium sulfate or hydroxyapatite). ) And other filled varieties (e.g., aluminum oxide, zirconium oxide, nitrided, etc.), PEEK, PEKK, PEKEK, PEI, PET, PETG, UHMWPE, PPSU, acetal, polyacetal, etc. It may be made from various materials including silicon, diamond-like carbon, etc., as well as various metallized ceramics, metal-ceramic compositions). Optionally, in any embodiment, the components of the Fusing Device 1000 are manufactured from a titanium alloy (including, but not limited to, a Ti-6Al-4V alloy) or a cobalt alloy including, but not limited to, a CoCrMo alloy. May be good. Optionally, in any embodiment, manufacturing some of the threaded components of the fusion device 1000 from a CoCr-based alloy allows for increased strength, reduced size, and other performance considerations.

Optionally, in any embodiment, bone homologous grafts, autologous bone grafts, heterologous grafts, desalted bone matrix products, synthetic bone substitutes, bone forming agents or other bone growth-inducing materials further promote or facilitate intervertebral fusion. Introduced in and / or around the healing device 1000. In one embodiment, the fusion device 1000 is preferably packed or injected with a bone graft, desalted bone matrix product, synthetic bone substitute, bone forming agent, or other bone growth-inducing material after it has been deployed. However, in other embodiments, the graft material may be introduced into and / or the space around the fusion device 1000 prior to implantation or after implantation but prior to deployment.

An exemplary healing device 1000 is shown in connection with FIGS. 3-5. FIG. 3 shows the fully folded state of the healing device 1000. FIG. 4 shows the deployed state of the healing device 1000. FIG. 5 shows a three-dimensional exploded view of the fusion device 1000. Optionally, in any embodiment, the fusion device 1000 comprises a first end plate 100, a second end plate 150, a third end plate 200, a fourth end plate 250, a proximal wedge 550, a distal wedge 650. Includes an actuator 500, a first lamp 300, a second lamp 350, a third lamp 400, a fourth lamp 450, a retaining pin 600 (most commonly seen in FIG. 5) and a retaining set screw 700. Optionally, in any embodiment, the first end plate 100, the second end plate 150, the third end plate 200, and the fourth end plate 250 are substantially identical, but all four. Although have the same set of mechanisms, the particular size and angular orientation of these mechanisms need not be the same in all embodiments or within any particular embodiment. Optionally, in any embodiment, the first lamp 300, the second lamp 350, the third lamp 400 and the fourth lamp 450 are substantially identical (the lamps are identical in some embodiments). On the other hand, it should be noted that they may or need to be suitably rotated or mirror-inverted in order to assemble into the arrangements shown in FIGS. 3-5), but all four are the same set of mechanisms. However, the particular size and angular orientation of these mechanisms need not be the same in all embodiments or within any particular embodiment. In addition, the effects of end plates, lamps and wedges with their ramp surfaces tilted at different angles with respect to the deployment characteristics of the fusion device 1000 are illustrated in more detail below.

As discussed in more detail below, the actuator 500 pulls the proximal wedge 550 and the distal wedge 650 together to force the first lamp 300 away from the third lamp 400 and also the second lamp. It functions to force the 350 away from the fourth lamp 450, which causes the end plates 100 and 150 to be forced away from the end plates 250 and 200 (leading to the width expansion of the fusion device 1000). ). Optionally, in any embodiment, the first lamp 300 and the second lamp 350 are pulled towards each other and the third lamp 400 and the fourth lamp 450 are pulled only after the width deployment is substantially completed. , Pulled towards each other. The movement of the first lamp 300 and the second lamp 350 toward each other forces the first end plate 100 away from the second end plate 150 and the movement of the third lamp 400 toward the fourth lamp 450. Forces the third end plate 200 away from the fourth end plate 250 (causing height expansion). The retaining pin 600 and the retaining set screw 700, in some embodiments, act to resist tension in the actuator 500 and maintain a linear position of the proximal wedge 550 with respect to the actuator 500. Optionally, in any embodiment, the subassembly comprising the actuator, the proximal wedge, the distal wedge, and the four ramps is collectively referred to as the actuator assembly.

Optionally, in any embodiment, only the lamps 300 and 350 and the lamps 400 and 450 begin to move towards each other after the width deployment has been substantially performed, and the lamps 300 and 400 have theirs relative to the proximal wedge 550. The limits of movement are substantially reached and the ramps 350 and 450 substantially reach their limits of movement relative to the distal wedge 650. Optionally, in any embodiment, this delay in height deployment slidably engages the proximal wedge 550 and the distal wedge 650 throughout the early part of the widening process, end plates 100, 150, 200, Achieved by 250. During the width unfolding process, as the wedges 550 and 650 move towards each other, they eventually disengage from the end plates 100, 150, 200, 250 and they unfold at height as will be discussed below. Allow to do. Optionally, in any embodiment, the delay in height expansion is further accomplished by an insertion instrument that constrains the height expansion until the width expansion is substantially performed, as will be discussed below.

When fully assembled, the first deployable fusion device 1000 most preferably has a full range of operation by the use of "ant joint" joint joints, such as fasteners such as pins, balls, screws, and set screws. A stable assembly of components that are all indwelled in the assembly over. Optionally, in any embodiment, the fastener is anchored to one component and moves through the mating mechanism of another component (such as a track), thereby allowing the range of motion of the first component by the track mechanism. Limited to a large amount, thereby preventing component dismantling.

In connection with FIGS. 6A-6F, FIGS. 6A and 6B show side and end views of the fusion device 1000 in the initial fully folded state, respectively, and FIGS. 6C and 6D show the fusion in the fully expanded state. A side view and an end view of the device 1000 are shown, respectively, and FIGS. 6E and 6F show a side view and an end view of the fusion device 1000 in a fully width and height unfolded state, respectively.

FIGS. 7A-7C illustrate a mechanism for delaying height expansion until width expansion is partially or substantially completed. In FIG. 7A, the fusion device 1000 is shown in the initial folded state, demonstrating the engagement of a proximal wedge 550 with a fitting mechanism for the end plates 100 and 150, in which state proximal. Pulling the wedge 550 and the distal wedge together results in a width deployment rather than a height deployment of the healing device 1000. Optionally, in any embodiment, as FIG. 7A, the engagement between the proximal wedge and the end plate prevents height deployment. Once widening occurs to the extent that the wedges disengage from the mating mechanism on the end plate (shown in FIG. 7B), further pulling the proximal wedge 550 and the distal wedge 650 together is high. It can result in either a shear-only deployment (shown in FIG. 7C) or a simultaneous deployment of height and width. Optionally, in any embodiment, the detachment of the proximal wedge from the end plate, FIG. 7B, allows for height deployment. Optionally, in any embodiment, the starting width is preferably 14 mm and height deployment begins when the width reaches about 20 mm. Optionally, in any embodiment, the height deployment may be initiated when the full maximum or substantial width is achieved (as discussed above). For height deployment to take place, the pair of lamps on any side of the fusion device 1000 must translate towards each other with respect to the end plate to which they are engaged, so height deployment. The delay in is achieved. This happens while the ramp surface of the wedge is simultaneously engaged with both the end plate and the ramp, as the end plate is rigid and spans the distance between the proximal wedge 550 and the distal wedge 650. No, thereby only widening is allowed until the condition shown in FIG. 3C is reached, in which point the wedge is still engaged with the ramp but no longer with the end plate. Pulling the wedges forward from this point together allows the ramps to move towards each other with respect to the end plates that result in height deployment. A detailed description of the components and their mechanics is provided below.

The following discussion relates to the first end plate 100, but in this embodiment the first end plate 100 is substantially the second end plate 150, the third end plate 200 and the fourth end plate 250. Being identical, it should be understood that it also applies equally to the second end plate 150, the third end plate 200 and the fourth end plate 250 (end plates are in some embodiments). It should be noted that while being identical, they may or need to be suitably rotated or mirror inverted in order to assemble into the arrangement shown above in the assembly shown in FIGS. 3-5). The end plates 100 and 250 are collectively referred to as the upper end plate, and the end plates 150 and 200 are collectively referred to as the lower end plate. The phrase "substantially identical" is the same or similar set in which all of its mechanisms perform the same or similar function in each of the end plates 100, 150, 200, as described below. Refers to the end plates 100, 150, 200 and 250 having the mechanisms of, while the particular size and angle orientation of these mechanisms is the same between the end plates 100, 150, 200 and 250 within any particular embodiment. It should be understood that they may or may not be the same.

Now, let us move on to FIGS. 8A and 8B, which show the bottom view and the top view of the end plate 100, respectively. Optionally, in any embodiment, the first end plate 100 has a first end 102 and a second end 104. In an exemplary embodiment, the first end plate 100 has an upper surface 134 connecting the first end 102 and the second end 104, and a lower surface connecting the first end 102 and the second end 104. The surface 132 is further included. Optionally, in any embodiment, the first end plate 100 is a first taper in close proximity to the first end 102, extending from the lower surface 132 to the upper surface 134, which are two tapered slots. Also includes a slotted 107 and a second tapered slot 109 in close proximity to the second end 104 extending from the lower surface 132 to the upper surface 134. Optionally, in any embodiment, the slopes or shapes of the tapered slots 107 and 109 are equal to or different from each other.

The first tapered slot 107 is substantially parallel to the major axis in some embodiments, but may be slanted or curved in a plane across the major axis in other embodiments 106. Containing a tapered surface 110 that substantially traverses the bottom surface 106, and a tapered surface 136 that is the opposite of the tapered surface 110 and substantially traverses the bottom surface 106, where the tapered surfaces 110 and 136 are the bottom. It tapers from the surface 106 toward each other and toward the inward surface 130. The bottom surface 108, where the second tapered slot 109 is substantially parallel to the major axis in some embodiments, but may be slanted or curved in a plane across the major axis in other embodiments, Containing a tapered surface 138 that substantially traverses the bottom surface 108 and a tapered surface 112 that is the opposite of the tapered surface 138 and substantially traverses the bottom surface 108, where the tapered surfaces 138 and 112 are bottoms. It tapers from the surface 108 toward each other and toward the inward surface 130.

The end plate 100 optionally further comprises a first relief 125 forming the planar surface 126 and a second relief 127 forming the planar surface 128. The first relief 125 extends from the first end 102 to the first tapered slot 107 and is defined by a planar surface 126 substantially parallel to the lower surface 132, the first relief surface 114 substantially. It is flat and parallel to the inward surface 130. The second relief 127 extends from the second end 104 to the second tapered slot 109 and is defined by a planar surface 128 substantially parallel to the lower surface 132, the second relief surface 116 being substantially. It is flat and parallel to the inward surface 130. Optionally, in any embodiment, the end plate 100 comprises a first chamfer 142 close to the first end 102 and a second chamfer 144 close to the second end 104. Chanfas 142 and 144 preferably have adjacent vertebral bodies 2 by reducing the height of the end plate 100 at the first end 102 and the second end 104, thereby providing a tapered leading and trailing edge. Facilitates the introduction and removal of the fusion device 1000 between and 4.

Optionally, in any embodiment, the end plate 100 further optionally further includes ramp grooves 122 and 118 close to the first end 102, and ramp grooves 124 and 120 close to the second end 104. The ramp grooves 122, 118 and 124, 120 are configured to engage the mating ramp shape of the proximal wedge 550 and the distal wedge 650, limiting the initial deployment of the fusion device 1000 to width deployment and the fusion device. Causes 1000 to prevent simultaneous deployment in width and height. The ramps 122, 118, 124 and 120 of the ramp grooves are configured to be combined with these wedges 550 and 650. The ramp grooves 124 and 122 are configured to fit into the trapezoidal (or, in other embodiments, T-shaped, Y-shaped, etc.) protruding shapes of the wedges 550 and 650. The ramp grooves 118 and 120 are preferably formed by two surfaces, a surface parallel to the bottom surface 132 and a surface perpendicular to it, respectively. The ramp grooves 118 and 120 are configured to fit into the protuberance balance of the wedges 550 and 650.

Now, let's move on to FIGS. 9A-9E. In an exemplary embodiment, where slots 107 and 109 have a trapezoidal cross section, they are optionally, but not limited to, a T-shaped cross section (shown in FIG. 9A), an L-shaped cross section (shown in FIG. 9B). , Y-shaped cross section (shown in FIG. 9C), F-shaped cross section (shown in FIG. 9D), or preferably they are at the bottom surfaces 106 and 108, or between the inward surface 130 and the bottom surfaces 106 and 108. It should be understood that in general any cross section may be arbitrary, resulting in thinner slots 107 and 109 on the inward surface than at any point. Optionally, in any embodiment, where retention of the lamp 300 within the end plate 100 is desired by a "split", tapered, T-shape or other slot shape, the above shape is preferred, for example, eg. An additional fastener (eg, a pin or set screw) installs the ramp 300 in slot 107 or 109 only to allow translation in one dimension (while rotation in one or more planes may also be allowed). The non-tapered, substantially linear cross section of slots 107 and 109 (shown in FIG. 9E), when used for holding, is advantageous. As various alternatives of end plates are shown herein as individual embodiments, it is also understood that these alternative embodiments have optional mechanisms that may be substituted or mixed / combined with any other embodiment herein. It should be. Replacing any of the above optional alternative mechanisms in end plate components is to use the reverse or complementary form of those mechanisms for proper engagement, fitting components (eg, end plates, Lamps, and wedges) may or will be required, and vice versa or complementary shaped shapes will inevitably be derived from the optional alternative mechanism forms described above. Should also be understood.

10A-10D3 show alternative embodiments of the end plate 100. In FIGS. 10A and 10B, the lower surface 132 has a protrusion 145 that shares a tapered surface 110 that includes a first tapered slot 107, and a protrusion 146 that shares a tapered surface 112 that includes a second tapered slot 109. An exemplary end plate 100 is shown, including further. 10A and 10B are shown. In aspects of FIGS. 10A and 10B, the lower surface 132 further comprises a recess 147 configured to receive the protrusion 146 of another end plate and a recess 148 configured to receive the protrusion 145 of another end plate. The purpose of the protrusions 145 and 146 and the recesses 147 and 148 is to end plates 100, 150, 200, 250 and ramps 300, 350 when the fusion device 1000 approaches the maximum height deployment state (shown in FIG. 10C below). , 400, 450, to increase the contact area and provide further stability. In embodiments that do not include protrusions 145 and 146, as the fusion device 1000 deploys in height, the lamp translates through the tapered slot of the end plate to cause deployment, and the contact area between the end plate and the lamp becomes. It will decrease steadily. The protrusions 145 and 146 compensate for this loss in the contact area, thereby improving the stability of the fusion device 1000 assembly. It should be understood that the same embodiments discussed above and shown in FIGS. 9A, 9B, 9C, 9D will apply equally to the embodiments shown in FIGS. 10A and 10B. Optionally, in any embodiment, some areas where the protrusions 145 and 146 create an additional contact area between the end plate and the ramp. Further, optionally, in any embodiment, the protrusions 145 and 146 and the fitting recesses 147 and 148 are depicted as substantially triangular in some embodiments, but the end plate 100 as the fusion device 1000 approaches the maximum height deployment state. , 150, 200, 250 and other shapes may achieve the same goal of increasing the contact area between the lamps 300, 350, 400, 450. FIG. 10C shows a fully deployed state of an exemplary fusion device 1000 including protrusions 145 and 146 and fitting recesses 147 and 148 on the end plate. Some areas where the protrusion creates an additional contact area between the end plate and the ramp are indicated and labeled. 10D1-10D3 show an exemplary fusion device 1000 in which the end plate 100 comprises a protrusion 143 on its proximal end. The protrusion 143 further includes an opening 149 configured to receive the bone fastener 730. The angle between the central axis of the opening 149 and the major axis of the end plate 100 may have any value between 0 and 90 degrees, but is most preferably 0 to 45 degrees and is generally 0 to 45 degrees. (However, the proximal portion of the bone fasina 730 in contact with the protrusion 143 (ie, the "head" of the fasuna 730) is more substantial than that of the body of the bone fasuna 730 in contact with the bone (ie, the shank of the fasuna 730). This is not always the case in embodiments that are substantially larger and the body is substantially smaller than the opening 149). As various alternatives of end plates are shown herein as individual embodiments, it is understood that these alternative embodiments have optional mechanisms that may be substituted or mixed / combined with any other embodiment herein. Should be. Replacing any of the above optional alternative mechanisms in end plate components is to use the reverse or complementary form of those mechanisms for proper engagement, fitting components (eg, end plates, Lamps, and wedges) may or will be required, and vice versa or complementary shaped shapes will inevitably be derived from the optional alternative mechanism forms described above. Should also be understood.

As illustrated in FIGS. 11A-12D, optionally, in any embodiment, for FIGS. 11A, 11D, and 12A, the top surface 134 of the first end plate 100 is substantially planar and the first end plate 100. Allows the upper surface 134 of the to engage with the adjacent vertebral body 2. Alternatively, the upper surface 134 is curved in one or more planes (shown in FIGS. 11B, 11C, 11F, 11H and 12B), allowing a higher degree of engagement with the adjacent vertebral body 2. Optionally, in any embodiment, the top surface 134 includes a substantially straight lamp surface (shown in FIGS. 11G and 12C) or a curved lamp surface (shown in FIGS. 11E, 11I and 12D), but in a substantially flat surface. be. The ramp surface engages with the adjacent vertebral body 2 in a lordotic fashion, eg, as shown in FIGS. 11E, and / or, for example, in a coronal tapering fashion, as shown in FIGS. 12C and 12D. Tolerate. Optionally, in any embodiment, different heights of non-lamp end plates, as well as arrangements of different height lamps and non-lamp end plates, also provide a suitable shape for lordotic engagement with the end plates. It is seen and illustrated in FIGS. 11D, 11F, 11H, and 11I. The lamp quality of the surface 134 is described as "lordosis" for FIGS. 11A-11I, as FIGS. 11A-11I and 12A-12D show the device 1000 at two different protrusions of 90 degrees from each other. It should be understood that FIGS. 12A-12D are described as "tapered". In one embodiment, all end plates in the fusion device 1000 have the same length, but in other embodiments, some or all of the end plates have different lengths to better adapt to the target anatomy. It is further contemplated that it may have. 13A and 13C show a fully folded and fully unfolded view of an exemplary fusion device 1000, where all end plates have the same length, FIGS. 13B and 13D show two end plates. Shows an exemplary fusion device 1000 with a shorter length than the other two, which appears to be advantageous in lateral approach applications and some posterior approach applications. Optionally, in any embodiment, the upper surface 134 comprises a textured 140 to aid in gripping adjacent vertebral bodies. In an illustrated embodiment, the texture ring 140 comprises a series of parallel grooves running laterally along the major axis of the end plate 100, where the texture ring is a tooth, a ridge, a region of high surface roughness, a relatively high surface roughness. Includes, but is not limited to, metal or ceramic coatings with degree, friction increasing elements, keels, spikes, or grips or lever protrusions. Optionally, in any embodiment, the one or more end plates are shorter, longer, thinner, or wider than the others. As various alternatives of the end plate are shown herein as individual embodiments, it is understood that these alternative embodiments have an optional mechanism that may be substituted or mixed / combined with any other embodiment herein. Should be. Replacing any of the above optional alternative mechanisms in the end plate component is for proper intended engagement between the various components of the fusion device 1000 and between these components and the surrounding anatomical structure. In order to use the reverse and / or complementary form of those mechanisms, fitting components (eg, end plates, lamps and wedges) may or will be required, and. It should also be understood that vice versa and / or complementary shaped shapes will inevitably be derived from the optional alternative mechanism forms described above.

The effect of changing the tilt and / or orientation of the tapered slots 107 and 109, or the amount of ramp and permissible movement between the ramp and the tapered slots 107 and 109 is seen and illustrated in FIGS. 14A-14B2. FIG. 14A shows the tilt and / or tilt of slots 107 and 109 on the four end plates viewed from the side, where the top surface of the device 1000 is represented by the end plate 250 and the bottom surface of the device is represented by the end plate 200. Or show the effect of changing the orientation. Changing the tilt of slots 107 and 109, or limiting the permissible movement between the ramp and slots 107 and 109 within the respective end plates, is without limitation on the top and bottom surfaces of the fusion device 1000. Unfold both uniformly, unfold both the top and bottom non-uniformly, unfold the top surface uniformly and the bottom surface non-uniformly, or unfold the bottom surface of the healing device 1000 uniformly and the top surface non-uniformly. The first end 102 and the second end 104 are brought about. FIGS. 14B1 and 14B2 show the initial completeness of the exemplary fusion device 1000 configured to unfold non-uniformly at its proximal and distal ends, leading to an unfolded state where the end plate tapers at an angle. A folded figure and an unfolded figure are shown respectively. Aspects of FIGS. 14B1 and 14B2 allow one end of the end plate and the end plate to allow the tapered slots 107 and 109 to make contact with a circular surface instead of the flat lamp surface of the other embodiment. An alternative aspect of the lamp 300 (discussed in detail below) suitable for non-uniform deployment with the other end is adopted, which also states that the long axis of the end plate is relative to the long axis of the lamp. Allows to be at a certain angle. The embodiments of FIGS. 14B1 and 14B2 further employ the mechanisms described in detail below, which independently limit the amount of movement between the ramp and the tapered slot 107 and the ramp and the tapered slot 109. For example, it allows the proximal end of the end plate to reach the end of its height deployment, and therefore the distal end of the end plate to stop unfolding before it does, which allows the proximal end to stop unfolding. After that, it results in continued deployment at the distal end of the end plate, thereby achieving greater height deployment than the proximal end in the fully deployed state.

Now moving on to FIGS. 15A-15G, the tilt and / or orientation of the ramp grooves 122, 118, 124 and 120 of the end plate 100, and the tilt and / or orientation of the complementary fitting mechanism of the ramp and wedge. The effect of changing is shown. FIG. 15A shows an end view of the fusion device 1000, where the top surface of the device 1000 is represented by the end plates 100 and 250 and the bottom surface of the device is represented by the end plates 150 and 200. FIG. 15A shows a mode in which both side surfaces of the fusion device 1000 are uniformly deployed, and a mode in which the left and right surfaces are uniformly deployed. FIGS. 15B, 15C and 15D show an exemplary fusion device 1000 in which the left and right surfaces of the fusion device 1000 unfold unevenly due to changes in the mating ramp mechanism of the end plates, wedges, and ramps. .. FIG. 15B shows a top view of the folded state of the embodiment and FIG. 15C shows a top view of the unfolded state of the embodiment, schematically showing the amount of width unfolding achieved in each direction. Not equal. FIG. 15D shows a perspective view of the unfolded state of the embodiment, allowing a better view of the difference in tilt of the lamp surface between the two sides of the fusion device 1000. FIG. 15E further shows an exemplary distal wedge 650 used in the assembly 1000 shown in FIG. 15D. FIG. 15F further shows an exemplary proximal wedge 550 used in the assembly 1000 shown in FIG. 15D. FIG. 15G further shows an exemplary lamp 300 used in the assembly 1000 shown in FIG. 15D. Now moving to FIG. 16, it modifies the tilt of slots 107 and 109 between the end plates, but illustrates the effect of keeping them the same within each individual end play, Healing Device 1000. Shown are end views of the four aspects of, which, without limitation, all four end plates deploy at the same speed, all four end plates deploy at different speeds, and any three. While the end plates deploy at the same speed, the fourth deploys at different speeds, while any two end plates deploy at one speed, the other two deploy at different speeds, May bring. In addition, bending slots 107 and 109 in a plane across the long axis of any end plate will preferably cause those end plates to tilt during the deployment shown in FIG. Where various alternatives of end plates, wedges, and lamps are shown herein as separate embodiments, these alternative embodiments provide an optional mechanism that may be substituted or mixed / combined with any other embodiment herein. It should be understood to have. Replacing any of the above optional alternative mechanisms in one component is for proper intended engagement between all of the various components of the fusion device 1000 and between these components and the surrounding anatomical structure. In order to use the reverse and / or complementary form of these mechanisms of, fitting components (eg, end plates, ramps and / or wedges) may or will be required. It should also be understood that, and vice versa, and / or complementary forms of shape will inevitably be derived from the optional alternative mechanism forms described above.

The following discussion relates to the first lamp 300, but in aspects of the present disclosure, the first lamp 300 is substantially identical to the second lamp 350, the third lamp 400 and the fourth lamp 450. So it should be understood that it also applies equally to the second lamp 350, the third lamp 400 and the fourth lamp 450 (while the lamps are identical in some embodiments, the figure. It should be noted that in the assembly shown in 3-5, it may or may not be suitably rotated in order to assemble to the arrangement shown above). The phrase "substantially identical" is the same set of lamps, all of which have the same or similar function in each of the lamps 100, 150, 200 and 250, as described below. While referring to the lamps 300, 350, 400 and 450 having mechanisms, the particular size and angle orientation of these mechanisms is the same between the lamps 300, 350, 400 and 450 within any particular embodiment. It should be understood that they do not have to be the same.

Now, moving on to FIGS. 17A and 17B, in some embodiments, the first lamp 300 has a first end 301 and a second end 303. In an illustrated embodiment, the first lamp 300 has an inner surface 305 connecting the first end 301 and a second end 303, and an outer surface connecting the first end 301 and the second end 303. Further includes a surface 307 (most commonly seen in FIG. 17B). The first lamp 300 further includes an upper surface 309 connecting the first end 301 and the second end 303, and a lower surface 311 connecting the first end 301 and the second end 303. The two surfaces 309 and 311 are preferably not necessarily parallel to each other. The first lamp 300 has an upper branch 321 extending preferably not necessarily beyond the outer surface 307 and the lower surface 311 and a lower branch 323 extending preferably not necessarily beyond the outer surface 307 and the lower surface 311. Further includes Prochubalance 315. The upper branch 321 includes a first lamp surface 302 and a second lamp surface 310, which extend outward from the inner surface 305 and taper outward in the direction of the outer surface 327 and are substantially trapezoidal to the upper branch 321. Gives a cross section. The lower branch 323 includes a first lamp surface 304 and a second lamp surface 312, which extend outward from the inner surface 305 and taper outward in the direction of the outer surface 327 and are substantially trapezoidal to the lower branch 323. Gives a cross section. Branches 321 and 323 are intended to slideably engage with tapered slots 107 and 109 on the end plate. The mating sections of the branches 321 and 323 and the tapered slots 107 and 109 are intended to be configured only to allow translation in one dimension, either straight or curved (mostly). Aspects may allow rotation in one or more planes).

As a remnant seen in FIG. 17A, the inner surface 305 preferably has a protrusion 319 forming a lamp surface 320 and a surface 325 that forms an angle greater than 90 degrees with the inner surface 305, as shown in FIG. 17A. include. The overhang 319 includes a first branch 314 and a second branch 316 and a groove 322. The groove 322 extends from the outer surface 307 toward the inner surface 305 along the lamp surface 320. The groove 322 does not extend through the surface 325 instead of terminating at the surface 324. As will be discussed below, the purpose of the channels 322 and surface 324 is to cause the mating mechanism on the lamp 300 to bottom out onto the surface 324, thereby causing the proximal wedge 550 and far away with respect to the lamp 300. It is to limit the operation of the position wedge 650. The channel 322 may further include a blind bore 308 matching the surface 324. The purpose of the bore 308 is to optionally accept a fitting pin to limit the amount of width expansion allowed. The branch 314 extends from the lamp surface 320 to the surface 329, and the branch 316 extends from the lamp surface 320 to the surface 330. The protrusion 319 further includes a relief 306 whose axis is substantially parallel to the major axis. The relief 306 is configured to fit into the actuator 500, otherwise allowing the lamps to be closer to each other than is possible without the relief 306. The relief 306 has any cross section suitable for accomplishing the above functions, such as a substantially linear cross section, or more preferably a partially polygonal cross section, or most preferably a circular cross section. The lamp surface 320 and the branches 314 and 316 form a tapered channel 328 with a substantially trapezoidal cross section. The tapered channel 328 has a trapezoidal cross section in an exemplary embodiment, but the cross section is not limited to the following, but is a T-shaped cross section (shown in FIG. 18C), a Y-shaped cross section (shown in FIGS. 18D and 18E). , L-shaped cross-section (not shown), F-shaped cross-section (not shown), or preferably they are thinner at the surface 329 than at the lamp surface 320 or at any point between the surface 329 and the lamp surface 327. It should be understood that generally any cross section may be included, resulting in a tapered channel 328. Optionally, in any embodiment, the tilt of the lamp surface 320 may or may not be the same between the lamps 350, 400, 450, 500 in the end plate.

In an exemplary embodiment, where the branches 321 and 323 have a trapezoidal cross section, they are not limited to, but are T-shaped, Y-shaped, L-shaped, or preferably they are on the outer surface 327. Or it should be understood that it may have generally any cross section that results in thinner branches 321 and 323 on the inner surface 305 than at any point between the inner surface 305 and the outer surface 327. 18A, 18B, 18C, 18D, 18E show some cross sections that branches 321 and 323 may take. Any aspect described herein may optionally have these cross sections in their branches. Considering manufacturability, L-shaped (FIG. 18A), U-shaped (FIG. 18B) and T-shaped (FIG. 18C) cross sections may be particularly preferred, but Y-shaped cross sections (FIG. 18D) and "inner T" shapes. Cross section (FIG. 18E) is also possible. Optionally, in any embodiment, the slopes of branches 321 and 323 are equal to or different from each other. Since the branches 321 and 323 are intended to engage slots 107 and 109, the effect of changing their tilt is the same as that discussed above for slots 107 and 109 in the end plate 100. .. Similarly, the effect of changing the tilt of the lamp surface 320 between each of the four lamps with respect to the deployment characteristics of the device 1000 is described above and can be seen in FIGS. 15A-15G above. In addition to the description of the figure, and in light of the detailed description of the specification of the lamp 300 provided herein, the tilt of the lamp surface 320 controls the width expansion of the device 1000, so that its tilt of each of the lamps. Changing (and changing the mating tilt of the ramp in the wedge in a complementary fashion) is not limited, but all four end plates expand at the same speed, the end plate on the right side surface. Deploys faster than the end plate on the left surface, and the end plate on the left surface deploys faster than the end plate on the right surface, or one, some, or all end plates are others. It should be understood that it may result in faster deployment than the one. As the various alternatives of the lamp are shown herein as individual embodiments, it is understood that these alternative embodiments have an optional mechanism that may be substituted or mixed / combined with any other embodiment herein. Should be. Replacing the above optional alternative mechanisms in any lamp component is to use the reverse or complementary form of those mechanisms for proper engagement, fitting components (eg, end plates, wedges, eg). It should also be understood that and / or actuators) will be required, and vice versa or complementary shaped shapes will inevitably be derived from the optional alternative mechanism forms described above. be.

Now moving on to FIGS. 19A-19H2, FIGS. 19A and 19B show alternative embodiments of the lamp 300, where branches 321 and 323 are centers thereof that are approximately perpendicular to the major axis of the lamp 300. It has a shaft, respectively, and includes substantially cylindrical (conical in other embodiments) projections 331 and 332. Optionally, in any embodiment, the protrusions 331 and 332 further include openings 334 and 335, respectively. The openings 334 and 335 have a central axis that coincides with the central axis of the protrusions 331 and 332, the opening being configured to engage the fastener 740, which in some embodiments is the openings 334 and 335, as well as the end plate. With a pin configured to engage a track 127A (most commonly seen in FIG. 19H2) extending to the bottom surface 108 of the 100 and a corresponding track (not shown) extending to the bottom surface 106 of the end plate 100. Yes (but in other embodiments it is a screw). When engaged with the corresponding track in the end plate 100, the fastener 740 may equally or preferentially limit the amount of translation allowed between the lamp 300 and the lamp slots 107 and 109 in the end plate 100. Intended. In an exemplary embodiment, the projections 331 and 332 are rectangular cross sections through their central axes or, but are not limited to, L-shaped cross sections (shown in FIGS. 19C and 19D), T-shaped cross sections (shown in FIGS. 19E and 19F). ), Trapezoidal cross-section (not shown), or preferably they are finer protrusions 331 and 332 on the inner surface 305 than at any point between the outer surface 327 or between the inner surface 305 and the outer surface 327. It should be understood that having a cross section that generally includes any cross section that results in. The articulation between these aspects of the ramp 300 and the end plate 100 is that the ramp 300 translates in the ramp slots 107 and / or 109 of the end plate 100 in only one dimension, and only one plane. Is intended to allow rotation within the slot.

19G1-19G3 show a cross-sectional view of an assembly of an exemplary end plate 100 and an exemplary ramp 300 articulated aspect, which is a blind slot and does not break through the bottom surface 132 of the end plate 100. Due to the T-slot 149, the lamp 300 is translationally limited within the lamp slot of the end plate 100 at one angle formed between the major axis of the lamp 300 and the end plate 100, while , Outside the functional and / or useful range of another angle (preferably the exemplary fusion device 1000) between the major axis of the ramp 300 and the end plate 100 (eg, and preferably the fusion device). It is possible to pass (between 1000 assemblies). 19H1 and 19H2 show a portion of an exemplary fusion device including an aspect of articulation between the ramp 300 and the end plate 100, where the ramp slot 109 of the end plate 100 has a substantially T-shaped cross section. The protrusion 331 of the lamp 300 has a substantially T-shaped cross section. The protrusion 331 further includes an opening 334 that is substantially concentric with it, wherein the opening 334 is configured to receive a fastener 740 containing a pin in this embodiment. The ramp slot 107 of the end plate 100 is further recessed in its bottom surface and further configured to engage the fastener 740 with the purpose of limiting the translational movement of the ramp 300 inside the slot 107 of the end plate 100. include. FIG. 19H1 shows a side view of the assembled joint joint, and FIG. 19H2 shows a three-dimensional exploded view of the joint joint. Both of the embodiments of FIGS. 19G1-19G3 and 19H1-19H2 are intended to cause non-uniform deployment of the distal and proximal ends of the healing device 1000 shown in FIGS. 14B1 and 14B2 above, but not limited to this. Intended to be useful. As the various alternatives of the lamp are shown herein as individual embodiments, it is understood that these alternative embodiments have an optional mechanism that may be substituted or mixed / combined with any other embodiment herein. Should be. Replacing the optional alternative mechanism in any one component is the proper and intended engagement between both of the various components of the fusion device 1000 and between these components and the surrounding anatomical structure. In order to use the reverse and / or complementary form of these mechanisms for, fitting components (eg, end plates, wedges and / or actuators) may or are required. It should also be understood that what will be and vice versa and / or complementary forms will inevitably be derived from the optional alternative mechanism forms described above.

Now, let's move on to FIG. Actuator 500 includes a proximal end 504, a distal end 502, and a cylindrical surface 506 connecting the proximal end 504 and the distal end 502. Optionally, in any embodiment, the actuator 500 further comprises a drive mechanism 512 close to the proximal end 504 and a thread 508 close to the distal end 502. The cylindrical surface 506 includes a groove 514 placed circumferentially around the actuator close to the drive mechanism 512 and a ridge 510 placed circumferentially around the actuator close to the thread 508. The ridge 510 is intended to act as a depth stop to limit the linear movement of the actuator 500 by creating contact with the distal wedge 650 at the end of the acceptable range of movement. In some embodiments, the drive mechanism 512 is shown as a hexarobula projection (external hexalove drive), but optionally, in any embodiment, the drive mechanism 512 is, but is not limited to, an internal hexalove, an external hexagon, an internal hexagon. , External cross, internal cross or any other shape. Optionally, in any embodiment shown in FIG. 21A, the drive mechanism 512 is a hexagonal recess (internal hexagonal drive). In addition, in the embodiment shown in FIG. 21A, the cylindrical surface 506 of the actuator 500 is circumferentially located around the actuator, close to the proximal end 504 but distal to the groove 514. Including further. The ridge 515 is configured to bottom out on the second end 560 of the proximal wedge 550 and is extruded through a central opening 568, a retaining pin 600, a retaining set screw 700, a retaining c-clip 720, or a high load. It is contemplated to provide resistance to the actuator 500 for some other actuator holding means against. FIG. 25 shows a cross-sectional view of the subassembly including the proximal wedge 550, the actuator 500, and the retaining c-clip 720, demonstrating the location and function of the ridge 515. Optionally, in any embodiment shown in FIG. 21B, the actuator 500 includes an additional thread 517 in close proximity to the proximal end 504. The thread 517 is composed of a spiral groove in the direction opposite to that of the thread 508 (that is, if the thread 508 is right-handed, then the thread 517 is left-handed). An additional effect of the thread 517 in the opposite direction is that the actuator 500 will be screwed into the proximal wedge 550 in a counterclockwise fashion, while screwed into the distal wedge 650, for example in a clockwise fashion. Yes, it causes the actuators 500 to translate again with respect to both wedges as they are twisted and actuated while pulling the wedges together. The degree of movement of the actuator 500 with respect to each wedge is placed by thread length or circumferentially around the actuator, where the thread runout will bottom out on each wedge, and each It is intended to be controlled by any of the dedicated ridges (eg, 510 and 515) configured to bottom out on the wedge, thereby limiting the translation of the actuator. As various alternatives of actuators are shown herein as individual embodiments, it is understood that these alternative embodiments have optional mechanisms that may be substituted or mixed / combined with any other embodiment herein. Should be. Replacing any of the above optional alternative mechanisms in actuator components is to use the reverse or complementary form of those mechanisms for proper engagement, fitting components (wedges, ramps, or actuators 500). It is also understood that (such as any auxiliary instrument intended to engage with) will be required, and that the shape of the opposite form will inevitably be derived from the optional alternative mechanism form described above. It should be.

With respect to FIG. 22, the retaining pin 600 includes a first end 604, a second end 602, and a cylindrical surface 606 connecting the ends 604 and 602, wherein the cylindrical surface 606 is a particular application. It may have any diameter and any length suitable for the fitting mechanism or component. With respect to FIG. 23, the retaining set screw 700 includes a first end 704, a second end 702, and a threaded surface 705 connecting the ends 704 and 702. The retaining set screw 700 further includes a drive mechanism close to the first end 704 and a cylindrical protrusion 710 extending from the second end 702. With respect to FIG. 24, the retaining c-clip 720 includes an inner diameter 724, an outer diameter 722, and a split 725 that shields both the inner diameter 722 and the outer diameter 724.

Further with respect to FIGS. 26A-26B, in an exemplary embodiment, the proximal wedge 550 has an upper surface 590 connecting the first end 562, the second end 560, the first end 562 and the second end 560. And a lower surface 552 connecting the first end 562 and the second end 560. The proximal wedge further includes a second lamp surface 582 located close to the first lamp surface 580 and the second end 560. The first lamp surface 580 includes a first protrusion 564 extending from the first lamp surface 580 towards the surface 565 and having a substantially trapezoidal cross section. The second lamp surface 582 includes a second protrusion 566 extending from the second lamp surface 582 towards the surface 567 and having a substantially trapezoidal cross section. Optionally, in any embodiment, the first overhang 564 comprises a protubalance 574 and the second overhang 566 comprises a protubalance 575. The protrusions 564 and 566 are one in such a manner that the ramp 300 only translates back and forth, in one dimension, with respect to the proximal wedge 550, either in a straight line or in a curved line (optionally, in any embodiment). Rotation in a plane may also be allowed between the lamp and the wedge 550), it is intended to be configured to slidably engage the tapered channel 328 of the lamp 300 at the end plate. Optionally, in any embodiment, the Protubalance 574 and 575 engage the groove 322 on the lamp 300 in the end plate, creating contact with the surface 324 to the extent of acceptable movement of the lamp. It is configured to limit the degree of translation between 300 and the wedge 550. Optionally, in any embodiment, in certain embodiments, the top surface 590 comprises a protrusion 554 extending from the top surface 590. The protrusion 554 includes a channel 599 that passes through the first end 562 but does not pass through the second end 560. Channel 599 is intended as a mating mechanism for auxiliary instruments used in the introduction, deployment and / or graft delivery to device 1000, as long as it is accessible from the first end 562, etc. It should be understood that they may be constructed, formed and positioned in the manner of. The proximal wedge 550 further includes a central opening 568 (shown in FIG. 19 as an example) and side openings 570 and 572 (shown in FIG. 26B as an example). Optionally, in any embodiment, the central opening 568 includes an undercut 571 and both the side-openings 570 and 572 are threaded. The central opening 568 is engaged with a threaded recess 586 and engaged with a retaining set screw 700 extending into the groove 514 of the actuator 500 and / or a bore 584 and extending into the groove 514 of the actuator 500. The 600, or the retaining c-clip 720 (see FIG. 24) that simultaneously engages the undercut 571 and groove 514 of the actuator 500, or allows the actuator 500 to rotate inside the central opening 568. The actuator 500 is configured to engage and hold the actuator 500 by any other holding mechanism that substantially prevents the actuator 500 from translating along the axis of the central opening 568.

In an exemplary embodiment, the first overhang 564 and the second overhang 566 are trapezoidal cross sections, or, but are not limited to, T-shaped cross sections, Y-shaped cross sections (not shown), or preferably they are surfaces 565 and 567. It should be understood that the lamp has a cross section that generally includes any cross section that results in narrow protrusions 564 and 566 at the lamp surfaces 580 and 582. Similarly, any aspect may optionally have the cross section described above. FIG. 27A shows an embodiment comprising protrusions 564 and 566 having a T-shaped cross section, which may be particularly preferred in view of manufacturability and performance.

Side openings 570 and 572 are intended as fitting mechanisms for auxiliary instruments used in the introduction and / or deployment of device 1000 and / or graft delivery to device 1000, which are accessed from the first end 562. Where possible, they may be configured, formed and positioned in other ways. As an example, there may be one or two side openings, one or both side openings may be threaded or none may be threaded, one or both. The side opening of may be non-circular. In addition, the central opening 568 is intended to engage the actuator and may or may not be at the geometric center of the proximal wedge 550 and may or may not be threaded. As an example, FIG. 27B shows an exemplary proximal wedge 550, where the central opening is left-handed and threaded (but in other embodiments right-handed and threaded). One of the side openings is threaded, and one of the side openings has a substantially rectangular, or preferably substantially quadrangular shape, which has a similar external dimension. It is considered advantageous for graft delivery to the fusion device 1000 as it may provide a larger cross-sectional area for the graft material to travel through compared to the circular opening. Other optional instrument attachment mechanisms are also contemplated to include, but are not limited to, aspects of the proximal wedge 550 shown in FIGS. 27B, 27C, and 27D. For example, the embodiment shown in FIG. 27B does not include a protrusion 554 and instead extends from a protrusion 587 and a protrusion 588 extending from the upper surface to form a channel 591, as well as extending from a lower surface 552 and channel 592. Includes overhangs 589 and 590 to form. FIG. 27C shows an aspect from FIG. 27B including a groove 592 extending from a protrusion 587 to a protrusion 589. Optionally, in any embodiment, another groove of similar dimension (not shown) may extend from protrusion 589 to protrusion 590. It is further envisioned that these grooves will act as an engaging mechanism for the auxiliary instrument. Aspects of FIG. 27C further include both a circular and threaded side opening and a non-threaded central opening. 27D is an embodiment from FIG. 27C further comprising a stepped recess 593 and 594 on the side surface of the proximal wedge 550 containing a deeper portion of the stepped recesses 593 and 594 located close to the second end 560. Is shown. Optionally, in any embodiment, the stepped recesses 593 and 594 will function as an engagement mechanism for the auxiliary instrument. Aspects of FIG. 27D further include one side opening that is circular and threaded, one opening that is substantially rectangular or preferably in the shape of a substantially square, and a central opening that is not threaded. Auxiliary instruments are discussed in detail below. Optionally, in any embodiment, the tilts of the lamp surfaces 580 and 582 (and the tilts of the lamp surfaces 680 and 682 discussed below) are equal to or different from each other. The branches of the lamp surface 580, 582 (and 680, 682 discussed below) of the wedge are intended to fit the lamp surface 320 of the lamps 300, 350, 400, 450, so their tilt. The effect of changing is the same as the discussion above for the lamp surface 320 in the lamp 300. As various alternatives of proximal wedges are shown herein as individual embodiments, it is understood that these alternative embodiments have optional mechanisms that may be substituted or mixed / combined with any other embodiment herein. It should be. Replacing the above optional alternative mechanisms in any proximal wedge component is to use the reverse or complementary form of those mechanisms for proper engagement, fitting components (eg, end plates). It should also be understood that a ramp, actuator and distal wedge) will be required, and vice versa the shape will inevitably be derived from the optional alternative mechanism form described above. ..

Now moving on to FIGS. 28A and 28B, in an exemplary embodiment, the distal wedge 650 connects the first end 662, the second end 660, the first end 662 and the second end 660. Includes an upper surface 690 and a lower surface 652 connecting the first end 662 and the second end 660. The proximal wedge further comprises a flat first ramp surface 680 and a flat second ramp surface 682 located close to the second end 660. The first lamp surface 680 includes a first protrusion 664 extending from the first lamp surface 680 towards the surface 665 and having a substantially trapezoidal cross section. The second lamp surface 682 includes a second protrusion 666 extending from the second lamp surface 682 towards the surface 667 and having a substantially trapezoidal cross section. Optionally, in any embodiment, the first overhang 664 comprises a protubalance 674 and the second overhang 666 comprises a protubalance 675. The protrusions 664 and 666 are tapered channels 328 of the ramp 300 at the end plate in such a manner that the ramp 300 only translates back and forth, in one dimension, with respect to the proximal wedge 650, either in a straight line or in a curve. It is intended to be configured to be slidably engaged with. Optionally, in any embodiment, the Protubalance 674 and 675 engage the groove 322 on the lamp 300 and create contact with the surface 324 to the extent of acceptable movement, thereby causing the lamp 300 and the wedge 650. It is configured to limit the degree of translation between and. Optionally, in any embodiment, in certain embodiments, the upper surface 690 further comprises a protrusion 654 extending from the upper surface 690 and a protrusion 655 extending from the lower surface 652. The protrusions 654 and 655 further include Changfa 688 and 689 configured to facilitate the introduction of the device 1000 during the initial extension of adjacent vertebrae 2 and 4. The distal wedge 650 further includes a central opening 668 and side openings 670 and 672. The central opening 668 is fully threaded and both the side-openings 670 and 672 are threaded. The central opening 668 is configured to engage the actuator 500. The side openings are intended as a fitting mechanism for auxiliary instruments used in the introduction and / or deployment of device 1000 and / or graft delivery to device 1000 and are configured, formed, and positioned in other ways. May be good. Optionally, in any embodiment, one or two side openings may be present, one or both side openings 670 and 672, whether threaded or both side openings 670 and 672. However, it does not have to be threaded, and one or both side openings 670 and 672 may be non-circular. FIG. 29A shows, by way of example, an exemplary distal wedge 650 without side openings. In an exemplary embodiment, where the first overhang 664 and the second overhang 666 have a trapezoidal cross section, they, or any other aspect disclosed herein, is a T-shaped cross section, but not limited to: , Y-shaped cross-sections, L-shaped cross-sections, or preferably any generally any cross-section that results in narrower protrusions 664 and 666 at the lamp surfaces 680 and 682 than at the surfaces 665 and 667. That should be understood. FIG. 29B shows an exemplary distal wedge containing protrusions 664 and 666 with a T-shaped cross section, which may be particularly preferred for manufacturability and performance considerations. Optionally, in any embodiment, the slopes of the lamp surfaces 580 and 582, as well as the slopes of the lamp surfaces 680 and 682, are equal to or different from each other. Since the branches of the lamp surface 580, 582, 680, 682 of the wedge are intended to fit the lamp surface 320 of the lamps 300, 350, 400, 450, the effect of changing their tilt is the lamp 300. It is the same as that discussed above for the lamp surface 320 inside. As various alternatives of the distal wedge are shown herein as individual embodiments, it is understood that these alternative embodiments have optional mechanisms that may be substituted or mixed / combined with any other embodiment herein. It should be. Replacing any of the above optional alternative mechanisms in the distal wedge component is to use the reverse or complementary form of those mechanisms for proper engagement, fitting components (eg, end plates). It should also be understood that a ramp, actuator and proximal wedge) will be required, and vice versa the shape will inevitably be derived from the optional alternative mechanism form described above. ..

Now let's move on to the method of implanting a fusion device between two adjacent vertebral bodies 2 and 4. FIGS. 30, 31, and 32 are reversibly attached to the fusion device 1000, allowing the fusion device 1000 to be implanted between adjacent vertebral bodies 2 and 4, and grafting onto the fusion device 1000. Aspects of the inserter 800 configured to facilitate delivery of the insert 800 are shown. Optionally, in any embodiment, the inserter 800 comprises an elongated body 820 having a substantially rectangular shape, but may have other shapes in other embodiments, most preferably in the initial folded state. It has a cross section that is substantially the same as the cross section of 1000. The inserter 800 further includes a threaded shaft 840 slidably arranged in the body. The body 820 further includes a distal end configured to fit into the proximal wedge 550 of the fusion device 1000 and includes three openings running over the entire length of the body 820. The first opening 821 allows the threaded shaft 840 to access one of the threaded side-openings of the proximal wedge 550 by screwing the threaded shaft 840 into the proximal wedge 550. Allows reversible attachment of the inserter 800 to the fusion device 1000. The second opening 822 allows the deployment drive instrument 870 to access the drive mechanism 512 of the actuator 500. The deployment drive instrument 870 is shown in FIG. 33, the distal end including the drive mechanism 877 adapted to the drive mechanism 512 of the actuator 500, and the torque used to actuate the actuator 500 and achieve the deployment of the fusion device 1000. Includes a proximal end including an attachment mechanism 875 for a handle, torque limited handle, or torque indicator handle. The third opening 823 allows access to the lateral opening of the proximal wedge 550 for the purpose of delivering therapeutic agents such as bone grafts or bone growth-inducing materials to the fusion device 1000 after deployment. The distal end of the body 820 further includes a flat plane forming the ledges 825 and 827, which is intended to prevent the height deployment of the fusion device 1000 until the width deployment is substantially complete. By screwing the threaded shaft 840 into the proximal wedge 550 (see Figure 34), once the inserter 800 is attached to the fusion device 1000, the fusion device 1000 is placed between adjacent vertebral bodies 2 and 4. It is embedded in (see FIG. 35). Once the initial embedded arrangement of the fusion device 1000 was found to be satisfactory, the deployment drive instrument 870 was slidably introduced into the second opening 822 in the inserter 800 and the drive mechanism 877 was the actuator 500. Is engaged with the drive mechanism 512 (see FIG. 36). The application of torque to the deployment drive instrument 870 results in the deployment of the fusion device 1000 at this stage. FIG. 37 partially covers the inserter 800 attached to the fusion device 1000 in the fully folded state and the end plate, thereby preventing height expansion of the fusion device 1000 but allowing width expansion. The ledge 825 to be used is shown. The ledge 825 of FIG. 37 is shown to cover a portion of the end plate to prevent height deployment of the fusion device 1000. FIG. 38 partially covers the inserter 800 attached to the fusion device 1000 and the end plate in the state of partial width deployment, thereby preventing the height deployment of the fusion device 1000, but with additional width. The ledge 825 which allows expansion is shown. FIG. 39 shows an inserter 800 attached to the fusion device 1000 in full width deployment and a ledge 825 that no longer covers the end plate, thereby allowing height deployment of the fusion device 1000. FIG. 40 shows an inserter 800 attached to a fusion device in a fully width and height unfolded state. The bone graft or bone growth-inducing material (graft material) is then introduced, delivered, or injected into the fusion device 1000 through the third opening 823 of the inserter 800. Optionally, in any embodiment, once the fusion device 1000 is implanted and unfolded, the inserter 800 is attached and a third opening before being packed into the fusion device 1000 through the third opening 823. The graft material may be pre-packed into the third opening 823 using an elongated tamp (not shown) configured to fit through section 823. After the device 1000 has been deployed by means including, but not limited to, syringes, funnels, screw-operated graft delivery devices or grip-operated graft delivery devices, the graft material is proximal to the third opening 823. It is further contemplated that it may be delivered to the opening. The elongated tamp is then used to extrude any graft material remaining inside the third opening 823 into the fusion device 1000. It is further contemplated that the graft material be introduced into the fusion device 1000 after it has been deployed and after the insertion instrument has been removed, the graft passing through any of the available openings in the proximal wedge 550. Or through the gap between the first facet end plate 6 and the proximal wedge 550, or through the gap between the second facet end plate 8 and the proximal wedge 550, or Introduced through both at the same time. FIG. 41 shows a fully deployed fusion device 1000, filled with bone graft material and still attached to the inserter 800. FIG. 42 shows a fusion device 1000 between two adjacent vertebral bodies 2 and 4 in a fully deployed state, filled with a bone graft and removed from the inserter 800. Implantation of the healing device 1000 is then completed and the surgical scar can then be closed.

FIG. 43 shows an exemplary insertion instrument. The inserter 900 includes a main shaft 955, a sleeve 930, a wheel 945, a handle 915, and pins 970 and 971. The main shaft 955 further includes a distal end configured to fit into the proximal wedge 550 of the fusion device 1000, and an outer thread located in close proximity to the proximal end. A detailed cross-sectional view of the threaded joint of the inserter can be seen in FIG. As shown in FIGS. 45 and 46, the main shaft further includes three openings running over the entire length of the main shaft 955. The second opening 961 allows the deployment drive instrument 870 to access the drive mechanism 512 of the actuator 500. The first opening 961 and the third opening 963 allow access to the lateral openings of the proximal wedge 550 for the purpose of delivering the bone graft or bone growth-inducing material to the fusion device 1000 after deployment. The distal end of the main shaft 955 further comprises a first tongue 956 containing a distal protrusion 964 and a second tongue 957 containing a distal protrusion 965. The tongues 956 and 957 are partially separated from the main bulk of the main shaft 955 by slits 958 and 959 that give the tongue flexibility. The distal end of the tongue is configured to engage the mating mechanism of an exemplary proximal wedge 550; this articulation is shown in cross section in FIG. The sleeve 930 is configured to slide the main shaft 955 by means of turning a wheel 945 that is contactably engaged with the main shaft 955 and rotationally engaged with the sleeve 930 by means of pins 970 and 971. Proceeding distally or proximally along the main shaft 955, which results in an indirect junction, which causes the wheel 945 to rotate with respect to the sleeve 930 but not translate against it. The handle 915 is firmly attached to the proximal end of the main shaft 955. When the sleeve 930 is in its closest position (shown in FIG. 48), the tongues 956 and 957 elastically deform from each other to engage the fitting mechanism on the proximal wedge 550 of the fusion device 1000. It is possible and when the sleeve 930 is in its most distal arrangement (shown in FIG. 49), it prevents the tongues 956 and 957 from elastically deforming from each other and the proximal wedge of the fusion device 1000. It results in a positive engagement between the 550 and the inserter 900. Further, in its most distal state, the sleeve 930 and especially its distal end perform the same function in the inserter 900 as the ledges 825 and 827 do in the inserter 800, which is substantially wide unfolded. It prevents the healing device 1000 from deploying at height until it is successfully completed. Once the inserter 900 is attached to the fusion device 1000, the fusion device 1000 is implanted between the adjacent vertebral bodies 2 and 4. Once the initial implant placement of the fusion device 1000 was found to be satisfactory, the deployment drive instrument 870 was introduced into the second opening 962 in the inserter 900 and the drive mechanism 877 was engaged with the drive mechanism 512 of the actuator 500. It is combined (see FIG. 50). The application of torque to the deployment drive instrument 870, at this stage, results in deployment of the fusion device 1000, first in width (see FIG. 51), then in both width and height (see FIG. 52). Delivery of the bone graft material to the fusion device 1000 through the inserter 900 can now be achieved through one or both of the openings 961 and 963 in the manner discussed above. FIG. 53 shows a fully deployed fusion device 1000 filled with bone graft material and still attached to the inserter 900. The inserter 900 can then be removed from the healing device 1000, the implantation of the healing device 1000 can then be completed, and the surgical scar can then be closed.

Second Deployable Healing Device Now, let us move on to FIGS. 54A-54C showing an exemplary second deployable healing device 1000a. FIG. 54A shows an exemplary second deployable fusion device 1000a in a fully folded state, and FIG. 54B shows an exemplary second deployable fusion device 1000a in a fully deployed state. FIG. 54C shows a three-dimensional exploded view of an exemplary second deployable fusion device 1000a. Optionally, in any embodiment, the second deployable fusion device 1000a is the aspect 300a of the first lamp 300 (and the lamps 350a, 400a and 450a, all of which are the same in this embodiment, wherein the lamp 400a is shown. (Used to mean a reference number for the lamp 300a in 54C) is the same as the exemplary embodiment of the first lamp 300, with the following exceptions: the outer surface 327 is the lamp of branch 323. The lamp slot 335a parallel to the surface, the branches 321 and 323 have a substantially C-shaped cross section, the surfaces 329 and 330 include protrusions 337a and 338a, the channel 328 has a substantially T-shaped cross section, and the lamp 300. It does not include the groove 322 that is present in the embodiments previously discussed for this purpose.

The second deployable fusion device 1000a is an embodiment 100a of the first end plate 100 (and end plates 150a, 200a and 250a, all of which are the same in this embodiment, but the second expandable fusion device 1000a. It may need to be suitably aligned in order to be assembled into the arrangement of the lamp slots 107 and 109, wherein the lamp slots 107 and 109 have a C-shaped cross section configured to fit the lamp 300a. The upper surface 132 includes a protrusion 145a close to the slot 109 and a recess 146a close to the lamp slot 107, while the protrusion 145a and the recess 146a have complementary shapes so that the two end plates are preferably rotated. If so, one protrusion 145a overlaps in the other recess 146a, allowing the lower surface of the top end plate to come into contact with the upper surface of the bottom end plate. The outward surface of the protrusion 145a further comprises a dibot 147a (shown on the end plate 200a in FIG. 54C), although it is generally aligned with the major axis of the lamp slot 335a of the lamp 300a when assembled. , Does not reach the other side of the end plate completely. The dibot 147a can have a spherical shape, a cylindrical shape (as shown) or any other shape. The purpose of the divot is to create an area of narrowed material between the bottom of the divot and the inward surface of the lamp slot 109, which deforms (stretches) the bottom of the divot, of the end plate. Allows the creation of protruding dimples 148a on the inward surface of slot 109. The stretching process is performed as the final step in the assembly process when the component is assembled and fully folded, punching that loads the underside of the divot by fitting, pressing or other means. Or performed by means of a pointed or round tool. As mentioned above, stretching creates dimples 148a on the inward surface of the end plate, which, in the assembled device state, engages these alongside the ramp recesses of the ramp and by superdeployment. These are captured and the disassembly of the second deployable fusion device 1000a is prevented. Optionally, in any embodiment, the dibot is replaced with a through opening in the end plate and the function of the stretched dimples is performed by a pin engaging the lamp slot of the lamp pressed through the end plate opening. To. The end plate 100a does not include the tapered grooves 122, 118, 124 and 120 that are present in the previously discussed aspects of the end plate 100, but instead show the lamp surfaces 121a and 123a (shown on the end plate 200a in FIG. 54C). Includes), which generally perform the same function as grooves 122, 118, 124 and 120, which prevents height expansion from occurring until the device is fully deployed in width. .. This is achieved through the lamp surfaces 121a and 123a that contact the wedge mating lamp surface during most of the width deployment process, while the lamps on the opposite sides of each end plate are in contact with the wedge. It can only move along the direction of the ramp surface of the wedge and the ramp surfaces 121a and 123a, during which time it is static with respect to each other, on the other hand, in order to achieve height deployment, the opposing lamps of the device. You need to be able to move towards each other along the long axis. Once the width rollout is substantially completed and once the ramp surfaces 121a and 123a are no longer in contact with the wedge, the ramps are allowed to move towards each other, resulting in a height rollout. Since the upper surface 132 further includes a protrusion 115a close to the lamp slot 107, the inward facing surface 130 includes a recess 117a close to the slot 109, while the protrusion 115a and the recess 117a have complementary shapes. When the two end plates are suitably rotated, one protrusion 115a overlaps in the other recess 117a, allowing the opposing upper and lower surfaces of the two top end plates to come into contact. The protrusion 115a is configured to fit the lamp 300a as an extension of the lamp surface of the lamp slot 107. The purpose of the protrusion 115a is to increase device stability at the upper limit of the allowable height deployment by maintaining a large contact area between the lamp and the end plate. The end plate 100a further includes an opening 119a extending from the inner surface to the outer surface. This mechanism is optional and is intended to allow the graft material to exit the device and fill the space surrounding it. The end plate 100a further includes a relief 149a whose axis is substantially parallel to the major axis. The relief 149a is configured to fit with the actuator 500a and to allow the end plates to be closer to each other than would otherwise be possible without the relief 149a.

The second deployable fusion device 1000a further includes aspects 500a of the actuator 500. Actuator 500a includes a proximal end 504a, a distal end 502a, and a cylindrical surface 506a connecting the proximal end 504a and the distal end 502a. Optionally, in any embodiment, the actuator 500a further comprises a drive mechanism 512a on the proximal end 504a, a thread 517a close to the proximal end 504a, and a thread 508a close to the distal end 502a. The thread 508a consists of a spiral groove in the direction opposite to that of the thread 508 (eg, if the thread 508a is clockwise, the thread 517a is counterclockwise and vice versa). This embodiment further comprises a second drive mechanism on the distal end (not shown). This second drive mechanism is considered useful during revision surgery, where the revision approach is not the same as the approach used during the original surgery.

The second deployable fusion device 1000a further comprises aspects 550a of the proximal wedge 550. Proximal wedges 550a are shown in anterior and posterior perspective views in FIGS. 55A and 55B, respectively. The proximal wedge 550a comprises a first end 562a, a second end 560a, an upper surface 590a connecting the first end 562a and the second end 560a, and a first end 562a and a second end 560a. Includes a lower surface 552 to connect. The proximal wedge further includes a first lamp surface 580a and a second lamp surface 582a located close to the second end 560a. The first lamp surface 580a includes a first lamp recess track 591a close to the upper surface and a second lamp recess track 592a close to the lower surface. The first lamp surface 580a further includes a protrusion 564a extending from the first lamp surface 580a toward the surface 565a and having a substantially T-shaped cross section. The protrusion 564a results in the lamp surface 580a being split into upper and lower portions. The second lamp surface 582a includes a first lamp recess track 593a close to the upper surface and a second lamp recess track 594a close to the lower surface. The second lamp surface 582 extends from the second lamp surface 582a towards the surface 567 and includes a protrusion 566 having a substantially T-shaped cross section. The protrusion 566a results in the lamp surface 582a being split into upper and lower portions. The ramp recessed tracks 591a, 592a, 593a, and 594a do not break through the side surface of the wedge 550a and serve as a depth stop for the protrusions 337a and 338a of the ramp 300a to bottom out, thereby serving as a proximal wedge. It works to limit the movement of the ramp to. The upper surface 590a further includes a protrusion 554a extending from the upper surface 590a. The lower surface 552a further includes a protrusion 555 extending from the lower surface 552a. The protrusions 554a and 555a include channels 599a and 598a extending through the first end 562a and the second end 560a. Channels 599a and 598a are intended as fitting mechanisms for the auxiliary instruments used in the introduction, deployment and / or graft delivery to the second deployable fusion device 1000a of the second deployable fusion device 1000a. It should be understood that they can be configured, formed and positioned in other ways as long as they are accessible from the first end 562a. The proximal wedge 550a further includes a threaded central opening 568a and a substantially square opening 570a and 572a that break through the respective sides of the proximal wedge 550a. The proximal wedge 550a further includes a partial bore 595a, which extends to some depth from the first end 562a to the second end 560a, but not all of it, and is threaded. The outer diameter of the central opening 568a is aligned with the center, and the thread is blocked. The partial bore 597a has access to the proximal end of the threaded actuator after the appliance has been deployed, and deforms the first thread on it using punches, awls, or automatic punching tools. Tolerate. This is done to prevent or reduce the chance of reverse threading of the actuator, leading to the device losing height after surgery.

The second deployable fusion device 1000a further comprises aspect 650a of the distal wedge 650 (most commonly seen in the three-dimensional exploded view in FIG. 54C). In this embodiment, the proximal wedge 650a is identical to the proximal wedge 550a, with the exception of a central opening in which the distal wedge 650a is screwed in the opposite direction to that of the proximal wedge. For example, if the central opening of the proximal wedge 550a has a counterclockwise thread, the central opening of the distal wedge 650a has a clockwise thread. Optionally, in any embodiment, having all of the insertion mechanisms that are also present on the proximal wedge and on the distal wedge along the actuator with the second drive mechanism on the distal end (above). (As discussed), useful during revision surgery, where the revision approach is not the same as the approach used during the original surgery. Optionally, in any embodiment, the distal wedge may have a more bullet-shaped distal end to facilitate initial implantation.

Where various alternatives of the various components are shown herein as individual embodiments, it is also understood that these alternative embodiments have optional mechanisms that can be substituted or mixed / combined with any other embodiment herein. Should be. Substitution of any of the above optional alternative mechanisms in any component may or may require the mating component to use the reverse or complementary form of those mechanisms for proper engagement. It is also understood that the shape of, and vice versa or complementary forms will inevitably be derived from the optional alternative mechanism forms described above and from the detailed description of the embodiments described as utilizing the forms. Should be. By way of example, the device second deployable fusion device utilizes actuator embodiments, height and width deploying mechanisms, configurations and embodiments, and some or any of the end plate stabilizing mechanisms and embodiments described herein. do.

Third Deployable Healing Device Now, let us move on to FIGS. 56A-56C showing an exemplary third deployable healing device 1000b. FIG. 56A shows an exemplary third deployable fusion device 1000b in a fully folded state, and FIG. 56B shows an exemplary third deployable fusion device 1000b in a fully deployed state. FIG. 56C shows a three-dimensional exploded view of an exemplary third deployable fusion device 1000b. The third deployable fusion device 1000b constitutes a transition from the initial folded state (shown in FIG. 56A) to the final unfolded state (shown in FIG. 56B), a previously discussed embodiment. Although having similar functionality to, deployment is achieved using an improved mechanism in which the lamp slot of the lamp 300b is configured to accept a pin 600 inserted through a fitting opening in the end plate 100b. .. Since the end plate 100b does not contain the lamp surface, height expansion is achieved by the pins 600 moving along the lamp slot and by the various curved surfaces of the end plate, making tangential contact with the lamp surface of the lamp. Disassembly by hyperdeployment is prevented by means by which the pin 600 bottoms out at the limits of movement allowed in the lamp slot of the lamp 300b. The third deployable fusion device 1000b comprises aspects 300b of the first lamp 300 (and lamps 350, 400 and 450, all of which are the same in this aspect) shown in the complementary diagrams in FIGS. 57A and 57B. Including, it has a first end 301b and a second end 303b. The first lamp 300b has an inner surface 305b connecting the first end 301b and the second end 303b, and an outer surface 307b connecting the first end 301b and the second end 303b (most in FIG. 57B). (Often seen) further. The first lamp 300b further includes an upper surface 309b connecting the first end 301b and the second end 303b, and a lower surface 311b connecting the first end 301b and the second end 303b. The two surfaces 309b and 311b are preferably parallel to each other. The first lamp 300b further comprises a procedure that further comprises an upper branch 321b that preferably extends beyond the outer surface 307b and the upper surface 309b, and preferably a lower branch 323b that extends beyond the outer surface 307b and the lower surface 311b. The balance 315b is further included. The upper branch 321b includes an upper end surface 341b, a first lamp surface 302b and preferably a second lamp surface 310b. The lower branch 323b includes a lower end surface 343b, a first lamp surface 304b and preferably a second lamp surface 312b. The inner surface 305b includes a protrusion 319b that forms the lamp surface 320b. The overhang 319b includes a first branch 314b and a second branch 316b. The first branch 314b extends from the lamp surface 320b to the surface 329b, and the second branch 316b extends from the lamp surface 320b to the surface 330b. The lamp surface 320b and the branches 314b and 316b form channels 328b having a substantially T-shaped cross section, in which the branches 314b and 316b extend and are parallel to the lamp surfaces 329b and 330b, respectively. It is formed due to the inclusion of each protrusion extending towards each other. The first branch 314b further comprises a protrusion 348b and the second branch 316b further comprises a protrusion 349b. The protrusion 319b further includes a relief 306b whose axis is substantially parallel to the major axis. The relief 306b is configured to fit with the actuator 500a and to allow the ramps to be closer to each other than would otherwise be possible without the relief 306b. The relief 306b has an arbitrary cross section suitable for achieving the above functions, for example, a substantially linear cross section. The lamp 300b is recessed into the inner surface 305b and extends from the central plane of the lamp 300b toward the upper branch 321b but does not break through the upper end surface 341b, and is recessed into the outer surface 327b of the lamp 300b. Further includes a second lamp slot 338b extending from the central plane towards the branch 323b but not breaking through the lower end surface 343b. The lamp 300b extends from the central plane of the lamp 300b toward the branch 321b and is located between the inner surface 305b and the inner margin of the protrusion 319b, the first lamp relief 341b, and the branch from the central plane of the lamp 300b. Further includes a second ramp relief 342b extending towards 323b and disposed between the inner surface 305b and the inner margin of the overhang 319b. The ramp tilt may or may not be parallel to each ramp slot, and the purpose of the ramp relief is to remove parts of the end plate during height deployment.

The third deployable fusion device 1000b comprises aspects 100b of the first end plate 100 (most commonly seen in FIG. 58) (and end plates 150, 200 and 250, all of which are the same in this aspect). Further included, which includes a first end 102b and a second end 104b. The first end plate 100b further includes an upper surface 134b connecting the first end 102b and the second end 104b, and a lower surface 132b connecting the first end 102b and the second end 104b. The first end plate 100b further includes a first elongated opening 107b close to the first end 102b and a second elongated opening 109b close to the second end 104b. The elongated openings 107b and 109b extend from the lower surface 132b through the upper surface 140b in a direction perpendicular to the major axis. The first end plate 100b extends from the first end 102b beyond the first elongated opening 107b to the first elongated recess 110b and from the second end 104b beyond the second elongated opening 109b. Further includes a second elongated recess 112b that extends. The elongated recesses 110b and 112b extend from the lower surface 132b toward the upper surface 140b in the direction perpendicular to the long axis without penetrating the lower surface 132b, forming a first inward direction 114b and a second inward direction 116b, respectively. do.

The lower surface 132b has a first protrusion 145b close to the opening 107b, a second protrusion 145b1 close to the opening 109b, a first recess 146b close to the first opening 107b, and a second opening. Includes a second recess 146b1 close to 109b. Here, since the protrusions 145b and 145b1 and the recesses 146b and 146b1 have complementary shapes, when the two end plates are folded relative to each other, one protrusion 145b overlaps in the other recess 146b1 and one protrusion 145b1. Overlap in the other recesses 146b, where the upper and lower surfaces of the two end plates are allowed to touch and the inner surfaces 130b of the two end plates are aligned. The center of the protrusion is configured to be generally aligned with the lamp slot of the lamp 300b when assembled. The protrusions 145b and 145b1 further include through openings 147b and 147b1, respectively, configured to receive pins that will engage the lamp slot of the lamp 300b. The inner surface 130b further includes a relief 149b whose axis is substantially parallel to the major axis. The relief 149a is configured to fit with the actuator 500b and to allow the end plates to be closer to each other than would otherwise be possible without the relief 149b. The inner surface 130b further includes an opening 119b extending from the inward surface to the outward surface. This mechanism is optional and is intended to allow the graft material to exit the device and fill the space surrounding it. The first inward 114b and the second inward 116b further include a first protrusion 118b and a second protrusion 120b, respectively. The protrusions are rounded on the surface facing each other. The round cross section of the protrusions 114b and 116b is configured for tangential contact with the lamp surfaces 310b and 312b of the lamp 300b to increase the contact area between the end plate and the lamp. The corners formed by at least the first end 102b and the inner surface 130b, and by the second end 104b and the inner surface 130b, include rounded surfaces 121b and 123b, respectively. The purpose of these rounded surfaces is to help prevent height unfolding until the device is fully unfolded in width. This is achieved through rounded surfaces 121b and 123b that tangentially contact the wedge mating ramp surface during most of the width deployment process, and while they tangentially contact the wedge, on the opposite sides of each end plate 100b. The lamp 300b can only move along the direction of the lamp surface of the wedges 550b and 650b because these lamp surfaces are in tangential contact with the round surfaces 121a and 123a, during which the lamps 300b are static with respect to each other. On the other hand, in order to achieve height deployment, the opposing lamps need to be able to move towards each other along the long axis of the device. Once the width rollout is substantially completed and once the round surfaces 121a and 123a are no longer tangentially in contact with the wedge, the lamps are allowed to move towards each other, resulting in a height rollout. The upper surface 134b includes a texturer 140b to assist in gripping adjacent vertebral bodies. In the illustrated embodiment, the texture ring 140b comprises a series of parallel grooves running laterally along the major axis of the end plate 100b, which are teeth, ridges, areas of high surface roughness, relatively high surface roughness. Includes, but is not limited to, metal or ceramic coatings with, but not limited to, friction increasing elements, keels, spikes, or gripping or lever protrusions. Optionally, in any embodiment, the one or more end plates can be shorter, longer, thinner, or wider than the others.

The third deployable fusion device 1000b further includes a proximal wedge 550a, a distal wedge 650a, an actuator 500a and a pin 600.

Where various alternatives of the various components are shown herein as individual embodiments, it is also understood that these alternative embodiments have optional mechanisms that can be substituted or mixed / combined with any other embodiment herein. Should be. Substitution of any of the above optional alternative mechanisms in any component may or may require the mating component to use the reverse or complementary form of those mechanisms for proper engagement. It is also understood that the shape of, and vice versa or complementary forms will inevitably be derived from the optional alternative mechanism forms described above and from the detailed description of the embodiments described as utilizing the forms. Should be. By way of example, a third deployable fusion device 1000b utilizes actuator embodiments, height and width deploying mechanisms, configurations and embodiments, and some or any of the end plate stabilizing mechanisms and embodiments described herein. Can be.

Fourth Deployable Healing Device Now, let us move on to FIGS. 59A-59C showing an exemplary fourth deployable healing device 1000c. FIG. 59A shows an exemplary fourth deployable fusion device 1000c in a fully folded state, and FIG. 59B shows an exemplary fourth deployable fusion device 1000c in a fully deployed state. FIG. 59C shows a top view of an exemplary fourth deployable fusion device 1000b. The fourth deployable fusion device 1000c, in the third deployable fusion device 1000c, includes an interlocking stabilization mechanism in which the end plates overlap (most commonly seen in FIG. 59D) to improve stability. And previously, except to ensure proper alignment, reduce "slop" between the top and bottom end plates on any side of the device, and allow it to facilitate even device deployment. It is the same as the third deployable fusion device 1000b described. Opposing end plates above and below the fourth deployable fusion device 1000c (FIG. 59D shows, for example, opposing end plates 100c and 150c) have protrusions 111c1 and 111c2 toward each other, as well as protrusions. Includes fitting recesses 113c1 and 113c2 that extend in length and pass through the upper surface of the end plate. Since the recesses further contain a dovetail track 103c2 on one end plate and a dovetail protrusion 103c1 (most commonly seen in FIG. 59C) on the opposite end plate, the mating end plate is of the dovetail track. It only moves one-dimensionally with respect to each other, either towards or away from each other along the long axis. Here, since the protrusions 111c1 and 111c2 and the recesses 113c1 and 113c2 have complementary shapes, one protrusion 111c1 overlaps in the other recess 113c2 and one recess 113c1 when the two end plates are suitably rotated. Accepts another protrusion 111c2, allowing the lower surfaces of the two end plates to come into contact and the inner and outer surfaces of the two end plates to be aligned. Stabilization mechanisms of this embodiment have been shown to slideably interconnect the upper and lower end plate portions, but the same arrangement is for slidingly interconnecting the upper or lower pair of end plate portions, or. It should be understood that both the top pair and the bottom pair are also used to slideably interconnect the top and bottom end plate portions.

Where various alternatives of the various components are shown herein as individual embodiments, it is also understood that these alternative embodiments have optional mechanisms that can be substituted or mixed / combined with any other embodiment herein. Should be. Substitution of any of the above optional alternative mechanisms in any component may or may require the mating component to use the reverse or complementary form of those mechanisms for proper engagement. It is also understood that the shape of, and vice versa or complementary forms will inevitably be derived from the optional alternative mechanism forms described above and from the detailed description of the embodiments described as utilizing the forms. Should be. As an example, the fourth deployable fusion device 1000c utilizes actuator embodiments, height and width deploying mechanisms, configurations and embodiments, and some or any of the end plate stabilizing mechanisms and embodiments described herein. Can be.

Fifth Deployable Healing Device Now, let us move on to FIGS. 60A-60C showing an exemplary fifth deployable healing device 1000d. FIG. 60A shows an exemplary fifth deployable fusion device 1000d in a fully deployed state, and FIG. 60B shows a side view of an exemplary fifth deployable fusion device 1000d in a fully deployed state. .. The fifth deployable fusion device 1000d comprises an interlocking stabilization mechanism in which the end plates overlap in the fifth deployable fusion device 1000d, which is described above for the device 1000c. The protrusions 111c1 and 111c2 also include curved protrusions llld3 and llld4, respectively, and the recesses 113c1 and 113c2 described above for device 1000c are curved to accommodate the curved protrusions llld3 and llld4 in an overlapping manner. It is identical to the previously described fourth deployable fusion device 1000c, except that it also includes reliefs 113d3 and 113d4, respectively. The curved protrusions are configured to make tangential contact with the lamp surface of the lamp 300b, thereby providing an additional contact point between the lamp and the end plate and at the upper limit of the allowed height deployment. Provides improved device stability. The end plate of the fifth deployable fusion device 1000d does not contain the lamp surface and relies on pin components to conduct the deploying force between the lamp and the end plate, which is due to the low contact area. Can lead to unwanted behavior (slops) between the components of. Adding a curved mechanism (such as curved protrusions llld3 and lld4) to the end plate allows the continuous contact surface between the lamp and the end plate to come close, thereby providing the stability described above. It will be improved.

Where various alternatives of the various components are shown herein as individual embodiments, it is also understood that these alternative embodiments have optional mechanisms that can be substituted or mixed / combined with any other embodiment herein. Should be. Substitution of any of the above optional alternative mechanisms in any component may or may require the mating component to use the reverse or complementary form of those mechanisms for proper engagement. It is also understood that the shape of, and vice versa or complementary forms will inevitably be derived from the optional alternative mechanism forms described above and from the detailed description of the embodiments described as utilizing the forms. Should be. By way of example, a fifth deployable fusion device 1000d utilizes actuator embodiments, height and width deploying mechanisms, configurations and embodiments, and some or any of the end plate stabilizing mechanisms and embodiments described herein. Can be.

Sixth Deployable Healing Device Now, let us move on to FIGS. 61A-61B showing an exemplary sixth deployable healing device 1000e. FIG. 61A shows an exemplary sixth deployable fusion device 1000e in a fully deployed state, and FIG. 61B shows a three-dimensional exploded view of an exemplary sixth expandable fusion device 1000e. The sixth deployable fusion device 1000e is an embodiment 100e of the first end plate 100 (and end plates 150, 200 and 250, where the end plates 100e and 150e are identical and the end plates 250e and 200e are ends. Includes mirrors of plates 100e and 150e), which are identical to end plate 100 with the following exceptions. In the end plate 100e, slots 107 and 109 have a substantially C-shaped cross section and have equivalent tilts tilted in the same direction, where both slots 107 and 109 start at the top surface 134 and are second. The lower surface 132 includes a protrusion 145e in the vicinity of the slot 109 and a recess 146e in the vicinity of the slot 107, wherein the protrusion 145e and the recess 146e have a complementary shape. When the top and bottom end plates are folded relative to each other, one protrusion 145a overlaps in the other recess 146e, allowing the upper and lower surfaces of the opposing end plates to come into contact. The protrusion 145e further includes an opening 147e (shown on the end plate 150a in FIG. 61B), which, when assembled, is generally aligned with the lamp slot 335e of the lamp 300e and is configured to receive the pin 600. This then engages the lamp slot at the lamp 300e.

The end plate 100e does not include the tapered grooves 122, 118, 124 and 120 that are present in the previously discussed aspects of the end plate 100, but instead includes the lamp surfaces 121e and 123e, which include the grooves 122, 118. , 124 and 120 generally perform the same function, which prevents height deployment from occurring until the device is fully deployed in width. This is achieved through the lamp surfaces 121e and 123e that contact the wedge mating lamp surface during most of the width deployment process, while the lamps on the opposite sides of each end plate are in contact with the wedge. It can only move along the direction of the ramp surface of the wedge as well as the ramp surfaces 121e and 123e, during which time it is static with respect to each other, where the opposing lamps are of the device to achieve height deployment. You need to be able to move towards each other along the long axis. Once the width rollout is substantially completed and once the ramp surfaces 121e and 123e are no longer in contact with the wedge, the ramps are allowed to move towards each other, resulting in a height rollout. The end plate 100e further includes an opening 119e extending from the upper surface to the lower surface in a direction perpendicular to the long axis. The purpose of the opening 119e is to be engaged by a mating protubalance 315e of the lamp 350e or 450e. The end plate 100a further includes a linear relief 149e spanning the distance between slots 107 and 109. The purpose of the relief 149e is to allow the lamps 300e and 400e to fit properly with the end plate.

The sixth deployable fusion device 1000e further includes a distal lamp 350e and a distal lamp 450e, which are identical and will be referred to hereafter as the distal lamp 350e. The sixth deployable fusion device 1000e further includes the proximal lamp 300e and the proximal lamp 400e, which are identical and will be referred to hereafter as the proximal lamp 300e. The distal lamp 350 is the same as the lamp 300b above, with the following exceptions: the distal lamp 350e does not include the lamp slot present in the Prochubalance 315b or the Lamp 300b, but instead contains the Protubalance 315e. It has an elongated shape that extends beyond the upper surface 309b, beyond the lower surface 311b, and beyond the outer surface 307b, and generally extends in the normal direction with respect to the upper and lower surfaces. The proximal lamp 300e is the same as the lamp 300b above, with the following exceptions: in the proximal lamp 300e, the lamp slot 337b faces the inner surface 305b as is done in the previously described lamp 300b. A recess into the outer surface 327b, which results in both lamp slots 337b and 338b being on the same side surface of the proximal lamp 300e and being merge together in the central plane. The proximal lamp 300e does not include the lamp reliefs 341b and 342b, the branches 323b and 321b of the protrusions 315b have a substantially C-shaped cross section, and the proximal lamp 300e is connected to the tip of the proximal lamp 300e by a gorge 315e2. And further includes a protrusion 315e1 forming the first end 301e of the proximal lamp 300e. The protrusion 315e1 is identical to the protrusion 315b, including having two lamp slots 338e and 337e recessed into the outer surface 327e, both of which are coplanar with the outer surface 327b. The tip of the protrusion 315e1 forming the first end 301e is cut so as to be shorter than that of the protrusion 315b.

The sixth deployable fusion device 1000e pushes the actuator 500a, the proximal wedge 550a, the distal wedge 650a, and the ramp slot 338b, 337b, 338e and 337e of the proximal lamp into the fitting opening of the end plate. It further includes a pin 600 configured to engage and provide stability and to prevent device disassembly due to hyperdeployment by bottoming out at the ramp slot at the end of maximum permissible movement and height deployment. In another aspect of the fusion device, after the sixth deployable fusion device 1000e has substantially reached the maximum width deployment, further drawing of the wedges both have the proximal and distal ramps towards each other. Cause to move. The proximal lamp is engaged with the lamp slot of the end plate, both in the direction of the major axis of the device and in the direction of height deployment with respect to the end plate, and between the mating lamp surface of the end plate and the proximal lamp. Height deployment is achieved by moving along an angle, where the distal ramp only moves in the direction of height deployment with respect to the end plate. Optionally, in any embodiment, a mating lamp slot to the end plate to replace the lamps 350e and 450e with the lamps 350a and 450a and to provide a mating geometry for the lamps 350a and 450a. The addition will result in embodiments with the desired features including improved end plate stability and easier and more uniform height deployment.

Where various alternatives of the various components are shown herein as individual embodiments, it is also understood that these alternative embodiments have optional mechanisms that can be substituted or mixed / combined with any other embodiment herein. Should be. Substitution of any of the above optional alternative mechanisms in any component may or may require the mating component to use the reverse or complementary form of those mechanisms for proper engagement. It is also understood that the shape of, and vice versa or complementary forms will inevitably be derived from the optional alternative mechanism forms described above and from the detailed description of the embodiments described as utilizing the forms. Should be. As an example, the sixth deployable fusion device 1000e utilizes actuator embodiments, height and width deploying mechanisms, configurations and embodiments, and some or any of the end plate stabilizing mechanisms and embodiments described herein. Can be.

Seventh Deployable Healing Device Now, let us move on to FIGS. 62A-62B showing an exemplary seventh deployable healing device 1000f. FIG. 62A shows an exemplary seventh expandable fusion device 1000f in a fully deployed state, and FIG. 62B shows a three-dimensional exploded view of an exemplary seventh expandable fusion device 1000f. In this embodiment, the lamp at the front end of the seventh deployable fusion device 1000f engages the rear lamp surface of the end plate and the lamp on the rear of the device engages the front lamp surface on the end plate. Causes the device to deploy at height so that both the front and rear ramps are forced together when the actuator is actuated. The seventh deployable fusion device 1000f is an embodiment 100f of the first end plate 100 (and end plates 150, 200 and 250, where the end plates 100f and 250f are the same, the end plates 150f and 200f are end plates. Includes 100f and 250f mirrors), where slots 107 and 109 have a "sideways T" shaped cross section, have equivalent tilts, and tilt in opposite directions, where slots 107f are internal. It extends through the surface 132f and the slot 109f extends through the outer surface 134f.

The end plate 100f does not include the tapered grooves 122, 118, 124 and 120 present in the previously discussed aspects of the end plate 100, but instead has a round surface 121f and a second surface in close proximity to the first end 102. Includes a round surface 123f close to the end 104, which performs generally the same function as grooves 122, 118, 124 and 120, which is height-expanded until the device is fully deployed in width. It prevents that. This is achieved through the round surfaces 121f and 123f tangentially in contact with the wedge mating lamp surface during most of the width unfolding process, while the lamps on the opposite sides of each end plate are in contact with the wedge. Since they maintain tangential contact with the round surfaces 121f and 123f, they can only move along the direction of the ramp surface of the wedge, during which time they are static with respect to each other, where height deployment is achieved. For this, the opposing lamps need to be able to move towards each other along the long axis of the device. Once the width rollout is substantially completed and once the round surfaces 121f and 123f lose their tangential contact with the wedge, the lamps are allowed to move towards each other, resulting in height rollout. Optionally, in any embodiment, the round surfaces 121f and 123f are also planar surfaces that are substantially parallel to the ramp surface of the wedge in order to achieve the same height expansion limiting effect described above.

The end plate 100f is not seen across the distance between the slot 107f and the second end 104, as well as the linear relief 149f, which is the same and spans the distance between the slot 109 and the first end 102. Further includes corresponding reliefs on other sides. The purpose of the relief is to allow the lamps 300f and 350f to fit properly with the end plate. The end plate 100f further comprises reliefs 149f3 on both the inner surface 132f and the outer surface 134f, the axes of which are substantially parallel to the major axis. The relief 149f3 is configured to fit with the actuator 500a and to allow the end plates to be closer to each other than would otherwise be possible without the relief 149f3. The reason for the existence of the two reliefs 149f3 is, as discussed above, that the end plate 100f is the same as the end plate 250, the end plate 150f is the same as the end plate 200f, and the end plate 100f is the seventh deployable. This is because the inner surface 132f of the end plate 100f can form either an inner or outer margin of the assembled device, depending on whether it is assembled in a left or right arrangement in the healing device 1000f. With this in mind, the end plate 100f includes two reliefs 149f3 to keep the left and right end plate components identical in this embodiment, but only one of the reliefs 149f3 in any given assembly. It actually contacts the actuator 500a at any given end plate.

The seventh deployable fusion device 1000f further includes a proximal outer lamp 300f and a distal outer lamp 450f, which are identical and will be referred to hereafter as the outer lamp 300f. The fusion device 1000e further includes a proximal medial lamp 400f and a distal medial lamp 350f, which are identical and will be referred to hereafter as the medial lamp 350f. Here, the lamps are described as inner and outer based on whether their lamp surface contacts the inner or outer slots in the end plate. The inner lamp 350f is the same as the lamp 300b above, with the following exceptions: the inner lamp 350f does not include the lamp slots 337b and 338b or the lamp reliefs 341b and 342b present in the lamp 300b, and the branches 321f and 323f , Has a sideways T-shaped cross section configured to fit into similarly shaped slots 107f and 109f of the end plate. The inner lamp 350f is longer than the lamp 300b and has a cut tip close to the first end 301b. Where the inner lamp 350f is configured to engage the inward slots of the end plate and to allow the outer lamp 300f to remove the outer surface of the outer lamp 350f, it is itself outside the end plate. Engage the oriented slots.

The outer lamp 300f is identical to the lamp 300b above, with the following exceptions: the inner lamp 300f does not include the lamp slot present in the lamp 300b, and the branches 321f and 323f are similarly shaped slots 107f of the end plate. And has a lateral T-shaped cross section configured to fit with 109f. The inner lamp 350f is longer than the lamp 300b and has a cut-out tip close to the first end. Further, the prochubalance 315f of the outer lamp 300f projects beyond both the outer surface 307f and the inner surface 305f, as opposed to the protubalance 315b of the lamp 300b, which only protrudes beyond the outer surface 307b. Where the outer lamp 300f is configured to engage the outward slots of the end plate and to allow the inner lamp 350f to remove the inner surface of the outer lamp 300f, it is itself inside the end plate. Engage the oriented slots.

The seventh deployable fusion device 1000f further includes an actuator 500a, a proximal wedge 550a, and a distal wedge 650a. In another aspect of the fusion device, after the device 1000e has substantially reached maximum width deployment, further pulling of the wedge both causes the proximal and distal ramps to move towards each other. The proximal lamp is engaged with the lamp slot of the end plate, both in the direction of the major axis of the device and in the direction of height deployment with respect to the end plate, and between the mating lamp surface of the end plate and the proximal lamp. Achieve height expansion by moving along an angle. Degradation through hyperdeployment of the seventh deployable fusion device 1000f is prevented using the various methods described in the other embodiments above, as well as those of skill in the art. One additional conceived method to achieve this is to assemble the device in a state of height deployment greater than the desired maximum allowed height, and then once the device is fully assembled, it is high. It is no longer acceptable for the seventh deployable fusion device 1000f to return the thread of the actuator 500a to its initial hyperdeployment state required for component assembly or disassembly. Is to transform in a way that makes it.

Where various alternatives of the various components are shown herein as individual embodiments, it is also understood that these alternative embodiments have optional mechanisms that can be substituted or mixed / combined with any other embodiment herein. Should be. Substitution of any of the above optional alternative mechanisms in any component may or may require the mating component to use the reverse or complementary form of those mechanisms for proper engagement. It is also understood that the shape of, and vice versa or complementary forms will inevitably be derived from the optional alternative mechanism forms described above and from the detailed description of the embodiments described as utilizing the forms. Should be. By way of example, the seventh deployable fusion device 1000f utilizes actuator embodiments, height and width deploying mechanisms, configurations and embodiments, and some or any of the end plate stabilizing mechanisms and embodiments described herein. Can be.

Eighth Deployable Healing Device Here we move on to FIGS. 63A-63D showing an exemplary eighth deployable healing device 1000g, where each of the end plates includes anterior and posterior portions. , Front and rear parts are cut-outs, and circular openings that allow the parts to be swivelly connected to the pins (or other parts of the part that engage the fitting recesses). (With one upper integrated cylindrical projection) is further included. Pins can be pressed or welded or machined into one part as protrusions and inserted into other parts, and their free ends are crimped to prevent disassembly. The lamp contains a cylindrical protrusion that engages the lamp slot in the wedge, which allows the lamp to both translate and rotate with respect to the wedge. The slot also limits how far the ramp translates with respect to the wedge, including the intended configuration, where translation is not possible and the ramp can only rotate with respect to the wedge. Since such a configuration is achieved by adjusting the length of the slots, in the initial folded state, the ramp only swivels or rotates with respect to their respective wedges as the width unfolds occur. .. The eighth deployable fusion device 1000g functions in the same manner as the fusion device 1000a, with the following exceptions. Eighth deployable fusion device 1000g ramp can both translate and rotate with respect to the wedge, combined with the fact that each of the end plates consists of two swivelly connected parts. Eighth deployable fusion device 1000g allows the opposing end plates to be translated away from each other and to articulate the end plates into a substantially diamond shape or square configuration in the wide unfolded state. By both doing, it brings about being able to unfold in width.

The eighth deployable fusion device 1000g is the aspect 100g of the first end plate 100 (and the end plates 150, 200 and 250, where the compound end plates 100g, 250g, 150g and 200g are all the same, but Includes (rotated relative to each other for proper assembly). The compound end plate 100g is the same as the above end plate 100a with the following exceptions. The compound end plate 100 g includes two portions 100 g1 and 100 g 2 swivelably connected to the pin 600 through the center of the compound end plate 100 g. Each of the portions 100g1 and 100g2 contains complementary reliefs 149g1 and 149g2 as well as circular openings 119g1 and 119g2, which, when concentrically aligned, have the upper and lower surfaces of the portions 100g1 and 100g2 approximately. It is permissible to be aligned in a coplanar fashion and to be allowed to swivel around the axes of the openings 119g1 and 119g2.

Eighth deployable fusion device 1000g is the aspect 300g of the lamp 300 (and the lamps 350, 400 and 450, where the lamps 300g, 350g, 400g and 450g are all the same in this aspect, but of the proper assembly. (Rotated relative to each other for) further includes. The lamp 300g is the same as the above lamp 300a with the following exceptions. The branches 316g and 314g form a channel 328g having a substantially square cross section, as opposed to a channel 328a of the lamp 300a having a T-shaped cross section. The surfaces 330a and 329a do not include protrusions 349a and 348a, as they do in the lamp 300a. The branches 316g and 314g further include the lamp surfaces 330g1 and 329g1 in addition to the lamp surfaces 330a and 329a of the lamp 300a, where the surfaces 330g1 and 329g1 are at an angle to the surfaces 330a and 329a. The branches 316g and 314g further include 349g and 348g of cylindrical protrusions, respectively. Here, the cylindrical projections share the same central axis and are tangent to the surfaces 330a, 329a, 316g and 314g. The purpose of the protrusions 349g and 348g is to engage the wedge fitting slots in a translational and swivel manner.

The eighth deployable fusion device 1000g further comprises 550g of aspects of the distal wedge 550. The distal wedge 550 g (shown in detail in FIG. 64) is identical to the distal wedge 550a with the following exceptions: The distal wedge 550 g does not include the ramp recess tracks 591a, 592a, 593a and 594a, but includes protrusions 564g and 566g, which form the ramp recess tracks 591g and 593g formed on the upper surface of the protrusions 564g and 566g, respectively. Also includes 592 g and 594 g of ramp recessed tracks formed on the lower surface of the protrusions 564 g and 566 g, respectively. The protrusions 555 g and 554 g include a lamp surface of 596 g and 579 g, which allow the end plate to move relative to the wedge once the eighth deployable fusion device 1000 g is fully deployed in width. It is composed. Channel 598g of the proximal wedge does not break through the protrusion 555g.

The eighth deployable fusion device 1000g further comprises 650g of aspects of the distal wedge 650. In this embodiment, the proximal wedge 650g is identical to the proximal wedge 550g, with the exception that the distal wedge 650a comprises a central opening screwed in the opposite direction of that of the proximal wedge. For example, if the central opening of the proximal wedge 550 g has a counterclockwise thread, the central opening of the distal wedge 650 g has a clockwise thread. Optionally, in any embodiment, all present on the proximal wedge and on the distal wedge along an actuator having a second drive mechanism on the distal end (as discussed above). Having an insertion mechanism is useful during revision surgery, where the revision approach is not the same as the approach used during the original surgery. Optionally, in any embodiment, the distal wedge may have a more bullet-shaped distal end to facilitate initial implantation.

The eighth deployable fusion device 1000g further includes an actuator 500a and a pin 600.

Where various alternatives of the various components are shown herein as individual embodiments, it is also understood that these alternative embodiments have optional mechanisms that can be substituted or mixed / combined with any other embodiment herein. Should be. Substitution of any of the above optional alternative mechanisms in any component may or may require the mating component to use the reverse or complementary form of those mechanisms for proper engagement. It is also understood that the shape of, and vice versa or complementary forms will inevitably be derived from the optional alternative mechanism forms described above and from the detailed description of the embodiments described as utilizing the forms. Should be. As an example, the eighth deployable fusion device 1000g utilizes actuator embodiments, height and width deployment mechanisms, configurations and embodiments, and any or any of the end plate stabilizing mechanisms and embodiments described herein. Can be.

Ninth Deployable Healing Device Now, let us move on to FIGS. 65A-65E showing an exemplary ninth deployable healing device 1000h. FIG. 65A shows an exemplary ninth deployable fusion device 1000h in an early folded state, and FIG. 65B shows an exemplary ninth deployable fusion device 1000h in a fully deployed state. FIG. 65C shows a partially assembled diagram of an exemplary ninth deployable fusion device 1000h in a folded state, FIG. 65D is an exemplary ninth unfolding in a fully linear width unfolded state. FIG. 65E shows a partially assembled diagram of a possible fusion device 1000h and FIG. 65E shows a partially assembled diagram of an exemplary ninth deployable fusion apparatus 1000h in a fully linear and angular unfolded state. .. In the ninth deployable fusion device 1000h, each of the end plates includes an anterior portion and a posterior portion, the anterior and posterior portions allowing a mating cut and a swivel connection of the portion to a pin. Further includes an opening (or with an integral cylindrical protrusion on one of the portions that engages a fitting recess in the other portion). Pins can be pressed or welded or machined into one part as protrusions and inserted into other parts, the free ends of which are crimped to prevent disassembly. The lamp contains a cylindrical protrusion that engages the lamp slot in the wedge, which allows the lamp to both translate and rotate with respect to the wedge. The slot also limits how far the ramp translates with respect to the wedge. The ninth deployable fusion device 1000h functions in the same manner as the third deployable fusion device 1000b, with the following exceptions. The ramp of the ninth deployable fusion device 1000h can both translate and rotate with respect to the wedge, combined with the fact that each of the end plates consists of two swivelly connected parts. The ninth deployable fusion device 1000h allows the opposing end plates to translate away from each other and to integrate the end plates into a substantially diamond shape or square configuration in the width-deployed state. Both of these bring about being able to unfold in width.

The ninth deployable fusion device 1000h is the aspect 100h of the first end plate 100 (and the end plates 150, 200 and 250, where the compound end plates 100h, 250h, 150h and 200h are all the same, but appropriate. Rotated relative to each other for assembly). The duplex end plate 100h is identical to the end plate 100b above, with the exception of having two rounded surfaces 121b and 123b for the end plate 100g, with the exception of including the two portions swivelably connected as described above. be.

The ninth deployable fusion device 1000h is an aspect 300h of the lamp 300 (and lamps 350, 400 and 450, where the lamps 300h, 350h, 400h and 450h are all identical in this aspect, but of proper assembly. (Rotated relative to each other for) further includes. The lamp 300h is the same as the lamp 300b described above, with some exceptions. Just as the above lamp 300g differs from the above lamp 300a, including having a cylindrical protrusion 349g (most commonly seen in FIG. 65C) and 348g (shown in the figure relating to the discussion of the device 1000g). , The lamp 300h is different from the lamp 300b. When the round surfaces 121b and 123b of the end plate 100h are concentric or substantially concentric with the cylindrical projections 349g and 348g of the lamp 300h in the ninth deployable fusion device 1000h in the initial folded state (this). The articulation is most commonly seen in FIGS. 65C, 65D and 65E), the ninth deployable fusion device 1000h, in which both the ramp and the end plate portion rotate relative to the wedge around a common axis in this scenario. It should be understood that due to the fact that it could be unfolded in width both linearly and angularly, it would start immediately in the initial folded state. Here, if the round surfaces 121b and 123b of the end plate 100h are not concentric or are accompanied by cylindrical protrusions 349g and 348g of the lamp 300h, the ninth deployable fusion device 1000h initiates width deployment in a linear fashion. Only contact can be angularly deployed after loss of contact between the round surface of the end plate and the wedge. This is because the round surface of the end plate and the cylindrical protrusion of the lamp are not coaxial, but still maintain simultaneous tangential contact with the lamp surface of the wedge, so the ninth deployable fusion device 1000h is sufficient in width. It cannot rotate with respect to the wedge until it is unfolded, where the round surface loses contact with the lamp surface of the wedge.

The ninth deployable fusion device 1000h further includes a proximal wedge 550g, a distal wedge 650g, an actuator 500a, and a pin 600.

Where various alternatives of the various components are shown herein as individual embodiments, it is also understood that these alternative embodiments have optional mechanisms that can be substituted or mixed / combined with any other embodiment herein. Should be. Substitution of any of the above optional alternative mechanisms in any component may or may require the mating component to use the reverse or complementary form of those mechanisms for proper engagement. It is also understood that the shape of, and vice versa or complementary forms will inevitably be derived from the optional alternative mechanism forms described above and from the detailed description of the embodiments described as utilizing the forms. Should be. As an example, the ninth deployable fusion device 1000h utilizes actuator embodiments, height and width deploying mechanisms, configurations and embodiments, and some or any of the end plate stabilizing mechanisms and embodiments described herein. Can be.

Tenth Deployable Healing Device Now we move on to FIG. 66A, which shows an exemplary tenth deployable healing device 1000k in a fully deployed state, where the tenth deployable fusion device 1000k is Includes an upper end plate 100k containing two parts 100k1 and 100k2 connected together to a single component by a series of diagonal deformable struts 100k3, and to a single component by a series of diagonal deformable stanchions 200k3. It further comprises a lower end plate 200k containing two portions 200k1 and 200k2 connected together. The portions 100k1, 100k2 and 200k1 and 200k2 can be identical to any aspect of the end plates 100, 150, 200, and 250 described above. The diagonally deformable struts 100k3 and 200k3 are chevron or V-shaped in this embodiment, but of any other suitable shape, including U-shaped, W-shaped, Z-shaped and the like. The stanchions increase through the width unfolding process from some initial angles in the initial folded state (shown in FIG. 66B) to larger angles in the fully width unfolded state (shown in FIG. 66C). , With an angle between the surfaces of the stanchions, is configured to deform during width deployment of the device. With the exception that the two parts of the upper and lower end plates are integrally connected by an oblique deformable strut, the component including the tenth deployable fusion device 1000k is any of the above embodiments. It is the same. During the width unfolding process, a series of diagonal deformable struts connecting the parts including the upper and lower end plates are plastically deformed by the action of actuators and wedges to make the upper and lower end plates initial. Permanently from the folded state (shown in FIG. 66D) to the width unfolded state.

Where various alternatives of the various components are shown herein as individual embodiments, it is also understood that these alternative embodiments have optional mechanisms that can be substituted or mixed / combined with any other embodiment herein. Should be. Substitution of any of the above optional alternative mechanisms in any component may or may require the mating component to use the reverse or complementary form of those mechanisms for proper engagement. It is also understood that the shape of, and vice versa or complementary forms will inevitably be derived from the optional alternative mechanism forms described above and from the detailed description of the embodiments described as utilizing the forms. Should be. As an example, the tenth deployable fusion device 1000k utilizes actuator embodiments, height and width deploying mechanisms, configurations and embodiments, and some or any of the end plate stabilizing mechanisms and embodiments described herein. Can be.

Eleventh Deployable Healing Device Now we move on to FIG. 67A, which shows an exemplary eleventh deployable healing device 1000m in a fully deployed state, where the eleventh deployable healing device 1000m is Includes an end plate complex 100 m (shown in FIG. 67B) comprising an upper portion 100 m1 and 100 m2 and a lower portion 200 m 1 and 200 m 2. Here, all four parts are integrally connected together by a series of diagonal (or, in other embodiments, curved) deformable struts, while the two upper parts are diagonally deformable. They are connected together by a strut 250m1 and the two lower portions are connected together by an oblique deformable strut 250m1, where the upper portion is connected to the lower portion by an oblique deformable strut 250m2. The portions 100m1, 100m2 and 200m1 and 200m2 can be identical to any aspect of the end plates 100, 150, 200 and 250 described above. The diagonally deformable struts 250 m1 and 250 m2 are chevron or V-shaped in this embodiment, but of any other suitable shape, including U-shaped, W-shaped, Z-shaped, and the like. The strut 250m1 is configured to deform with width unfolding, and the strut 250m2 is fully widened from some initial angle in the initial folded state (shown in FIG. 67C) (shown in FIG. 67D). It is configured to deform with height deployment of the device, with an angle between the surfaces of the stanchions, which increases throughout the deployment process, as well as to greater angles in full width and height deployment. With the exception that the portion of the end plate is integrally connected to the end plate complex 100 m by an oblique deformable strut, the component including the eleventh deployable fusion device 1000 m is any of the above embodiments. It is the same. During equipment deployment, a series of diagonal deformable struts connecting the parts containing the end plate complex were plastically deformed by the action of actuators, wedges and ramps to initially fold the end plate complex 100 m. Permanently from the state, the width to the unfolded state, and then to the width and height unfolded state.

Where various alternatives of the various components are shown herein as individual embodiments, it is also understood that these alternative embodiments have optional mechanisms that can be substituted or mixed / combined with any other embodiment herein. Should be. Substitution of any of the above optional alternative mechanisms in any component may or may require the mating component to use the reverse or complementary form of those mechanisms for proper engagement. It is also understood that the shape of, and vice versa or complementary forms will inevitably be derived from the optional alternative mechanism forms described above and from the detailed description of the embodiments described as utilizing the forms. Should be. By way of example, the eleventh deployable fusion device 1000m utilizes actuator embodiments, height and width deploying mechanisms, configurations and embodiments, and some or any of the end plate stabilizing mechanisms and embodiments described herein. Can be.

Twelfth Deployable Healing Device Now, let us move on to FIGS. 68-72C showing an exemplary twelfth deployable healing device 1000n and its components. FIG. 68 shows an exemplary twelfth deployable fusion device 1000n in its initial folded state, which is identical to the third deployable fusion device 1000b described above, with the following exceptions. .. The twelfth deployable fusion device 1000n includes a proximal wedge 550n, which is identical to the proximal wedge 550a with the following exceptions: Proximal wedges 550n (shown in FIGS. 69A and 69B) include side openings 570n and 572n, which are substantially circular in cross section and do not break through the side walls of the wedge (although they may break through in other embodiments). ), Tilt toward the center line of the proximal wedge 550n. The proximal wedge 550n further comprises a stepped central opening 568n, which further comprises a through recess 568n1 and a blind bore 568n2 close to the first end 562n, where the blind bore 568n2 is the first. Includes a threaded cross section close to the end 562 of. The proximal wedge 550n does not include the channels 598a and 599a present in the proximal wedge 550a.

The twelfth deployable fusion device 1000n further includes a distal wedge 650n (shown in FIGS. 70A and 70B), which is identical to the proximal wedge 550n with the following exceptions. The distal wedge 650n does not include a central opening and instead includes a threaded blind bore 668n through a second end 660n, which is generally aligned with the central opening 568n of the proximal wedge 550n. The distal wedge 650n further includes a relief groove 662n1 close to the first end 662n intended to supplement the thickness of the pull member that loops around the wedge and engages the side openings.

The twelfth deployable fusion device 1000n further includes a flexible tension member 715n that loops through the side openings 670n and 672n of the distal wedge 650, where the free ends of the tension member 715n are the side openings 570n and Further past 572n, extending from the first end 562n of the proximal wedge 550n, where these free ends are then tied or clamped to an actuator (not shown) of the inserter / puller tool. Alternatively, it may be constrained or linked. The flexible tension member 715n may include a bundle of sutures, tapes, fibrous ropes, monofilaments or any of the above and may be made from one or more of the following: polymers (eg, UHMWPE, PET, nylon, PEEK, Kevlar). Etc.), metal (eg titanium, titanium alloys, stainless steel, CoCrMo, etc.) or other fibers such as silk, carbon fiber, etc.

The twelfth deployable fusion device 1000n further includes a set screw 700n (most commonly seen in FIG. 71), which is identical to the set screw 700 described above, with the following exceptions; the drive mechanism 708n Over the entire set screw (which can be hexagonal, hexalove, trefoil, square, double square, etc.), the set screw 700n is compared to the set screw 700 to function better as described below. Big. While the set screw 700n is screwed into the threaded portion of the bore 568n2 of the proximal wedge 550n and is configured to contact the flexible tension member 715n (when actuated or tightened), it is , Passing through the side openings 570n and 572n of the proximal wedge 550n at the pinch point shown in FIG. 72C. The through drive mechanism of the set screw 700n is configured to pass through the threaded shaft 840n of the tensioning instrument (not shown in its entirety) (engaged with the threaded shaft 840n of the tensioning instrument in the fully folded state. Also first seen in FIG. 71 showing a twelfth deployable fusion device 1000n), allowing it to access the threaded recess 668n of the distal wedge (in the fully folded state of the tensioning instrument). Most commonly seen in FIG. 72A, which shows a cross-sectional view of a twelfth deployable fusion device 1000n engaged with a threaded shaft 840n), through which the graft material enters the interior of the device 1000n after the device has been deployed. Is further allowed to be delivered (as seen in the cross-sectional view of the twelfth deployable fusion device 1000n in FIG. 72B), the threaded shaft 840n is drawn withdrawn, and the set screw 700n is activated or tightened. The flexible tension member 715n is then locked by contacting it at the pinch point shown in the cross-sectional view of the twelfth deployable fusion device 1000n in FIG. 72C, whereby the flexible tension member 715n is It causes the vertebral body to retain the tension generated by applying the compressive force to the end plate, which allows the twelfth deployable fusion device 1000n to be held in its unfolded state.

Fusion Unlike the third deployable fusion device 1000b, the twelfth deployable fusion device 1000n does not include the actuator 500a and instead results in the deployment of the fusion device 1000n and the twelfth in the desired state of deployment. The functionality of the threaded (or more generally linear) actuator 500a that maintains the deployable fusion device 1000n is split between the threaded shafts 840n of the tensioning instrument (all of which are not shown here). ), It is screwed into the distal wedge 650n and has the linear tension applied to it by the tensioning instrument, while the body of the tensioning instrument at the same time the proximal wedge 550n has the proximal and distal wedges 550n and 650n. Withstanding causing movement towards each other, a twelfth deployable fusion device 1000n causes deployment in the manner described above for other aspects of the device and is attached to the tensioning instrument during device deployment. The flexible tension member 715n allows the twelfth deployable fusion device 1000n to be maintained in the desired deployment state by means of tightening the set screw 700n. The tension member 715n also ties the ends of the tension member, or is widely understood, known and utilized in the design of suture anchors and buttons used in orthopedics, such as tension loss or slippage of the tension member. It should be understood that it can be locked by other means than the set screw 700n, including the adoption of other means to prevent. The ends of the tension member 715n may need to be cut off after the unfolding and locking steps.

Where various alternatives of the various components are shown herein as individual embodiments, it is also understood that these alternative embodiments have optional mechanisms that can be substituted or mixed / combined with any other embodiment herein. Should be. Substitution of any of the above optional alternative mechanisms in any component may or may require the mating component to use the reverse or complementary form of those mechanisms for proper engagement. It is also understood that the shape of, and vice versa or complementary forms will inevitably be derived from the optional alternative mechanism forms described above and from the detailed description of the embodiments described as utilizing the forms. Should be. By way of example, a twelfth deployable fusion device 1000n utilizes actuator embodiments, height and width deploying mechanisms, configurations and embodiments, and any or any of the end plate stabilizing mechanisms and embodiments described herein. Can be.

Thirteenth Deployable Healing Device With reference to FIGS. 73A-74B, FIGS. 73A, 73B, 73C, and 73D show end plates 100a, 150a, 200a and 250a (all identical in this embodiment), ramps 300p, 350p, 400p. And 450p (all identical in this embodiment), proximal wedge 550p, distal wedge 650p (distal and proximal wedges are identical in this embodiment) and an exemplary thirteen deployable including actuator 500a. The initial folded state of the fusion device 1000p, the fully expanded state, the completely unfolded state and the three-dimensional exploded view are shown. The thirteenth deployable fusion device 1000p is the same as the second deployable fusion device 1000a described above, with the following exceptions. The lamps 300p are not tilted on the surfaces 320p, 329p, and 330p, but generally traverse the major axis of the thirteenth deployable fusion device 1000p (these are the fitting of the details of the wedge). Described above, with the exception of (either perpendicular to the major axis of the device or angled to the major axis, as shown, depending on whether the surface is perpendicular to the major axis of the device or at an angle). It is the same as the lamp 300a of. The distal wedge 650p is identical to the distal wedge 650a described above, with the following exceptions. It should be noted that although the distal wedge 650a was described above as merely identical to the proximal wedge 550a, the proximal wedge 550a is described in the detailed description. The surfaces 680p and 682p are not tilted with respect to each other, as is the corresponding surface of the wedge 650a, but instead are generally parallel and generally transverse to the major axis of the thirteenth deployable fusion device 1000p. (Optionally, in any embodiment, they are either vertical as shown or angled with respect to the major axis of the device). Surfaces 680p and 682 further include slots 691p and 692p, respectively, which penetrate one side of the wedge, but not the other side of the wedge, and the slot does not penetrate the side wall of the wedge 650p. Serves the purpose of limiting the translation of the ramp to. To limit the translation of the ramp to the wedge on the other side of the wedge, the slot opening can be plastically deformed or "saged" after assembling the device to prevent disassembly. In addition, the upper and lower surfaces 652p and 690p of the distal wedge 650p do not contain protrusions or channels as in the wedge 650a. The distal wedge 650p is identical to the proximal wedge 550p.

The mating slide surfaces of the ramps and their respective mating wedges are generally collectively parallel and transverse (vertical or angled as shown) with respect to the major axis of the thirteenth deployable fusion device 1000p. Therefore, due to this arrangement, the thirteenth expandable fusion device 1000p cannot expand its width when the actuator 500a is activated. Instead, when the actuator 500a is actuated, the device 1000p only deploys at a height, which is different from all behaviors of the previously described embodiments. Since the mating slide surface of the ramp and wedge is collectively parallel and transverse to the major axis, the thirteenth deployable fusion device 1000p is widened by the application of external forces, eg, by an insertion / deployment instrument. Deployed in. As such, the articulation between the ramp and wedge does not act as a deployment mechanism, but simply keeps the components of the device in proper alignment while preventing disassembly at the upper limit of deployment of the instrument-affected width. Currently, the width expansion is independent of the height expansion and is useful in some applications. 74A and 74B show the insert-deployment instrument 840p in the initial folded and fully unfolded state and the thirteenth deployable fusion device 1000p assembled, respectively. The insert-deployment instrument 840p (not shown in its entirety) is a set that is pulled together or forced apart using screwing, gripping, or any other mechanism (not shown). Includes a front wedge 840p1 and a set of rear wedges 840p2. The insertion-deployment instrument engages with a thirteenth expandable fusion device 1000p in the fully unfolded state of the device, after which the device is folded to its initial state for insertion. When inserted into the disc space, the anterior and posterior wedges of the instrument are pulled together and the thirteenth deployable fusion device 1000p prevents the anterior wedge from contacting the device 1000p (most commonly seen in FIG. 74B). State), and expand the width to the expanded width to be pulled out. When that happens, the height of the device is unfolded. This arrangement means that in order for the instrument 840p to be removed from the thirteenth healing device 1000p, the width that allows the device to pull out the anterior wedge must be fully deployed. Optionally, in any embodiment, a plurality of different front wedge widths can be supplied to the end user so that the optimal target deployment width for detailed application can be determined. Manipulating the width deployment with two opposing wedges, but without a dovetail, hook, L-shape or other articulation between the anterior wedge and the posterior wedge and the device, from a wider state. It does not allow it to be reduced to a narrower state, thereby allowing the instrument to exert both tension and compression on the device, thereby expanding and folding the width of the device as discussed above. Allow both. This functionality is considered in the following embodiments. At this point, all deployment mechanisms and configurations described above, with the exception of the device 1000p, are configured to allow deployment of the device in both width and height by reversing the working direction. It should also be mentioned that all of the tilted joints described above, with the exception of the thirteenth deployable fusion device 1000p, are of tensile and compressive forces. This is because it has sloping front-facing and rear-facing contact surfaces that allow both to be taken, and deploying and deploying these devices by operating the actuators in the "forward" and "reverse" directions, respectively. Can be folded.

Although various alternatives of the various components are presented herein as separate embodiments, these alternative embodiments have any mechanism that can be substituted or mixed / matched with any other aspect herein. Should also be understood. Also, if any of the above-mentioned alternative functions in any component is replaced and a mating component is needed to use the reverse or complementary form of those functions for proper engagement. And the shape of the reverse or complementary form inevitably arises from any alternative mechanism form described above and a detailed description of the embodiments described as utilizing that form. Please understand that it will be. As an example, the thirteenth deployable fusion device 1000p utilizes some or any of the actuator embodiments, height and width deployment mechanisms, configurations and embodiments, as well as end plate stabilizing mechanisms and aspects described herein. You may.

14th Deployable Fusing Device With reference to FIGS. 75A-75E, FIGS. 75A, 75B, 75C, 75D and 75E are end plates 100r, 150r, 200r and 250r (all identical in this embodiment), ramps 300r, 350r, An exemplary 14th deployable, including 400r and 450r (all identical in this embodiment), proximal wedge 550p, distal wedge 650p (distal and proximal wedges are identical in this embodiment) and actuator 500a. The initial folded state of the union device 1000r, the fully unfolded state, the fully unfolded state, the completely unfolded state and the completely wide and high unfolded state and the three-dimensional exploded view are shown. The 14th deployable fusion device 1000r is the same as the 13th deployable fusion device 1000p described above, with the following exceptions. The end plate 100r has a first end 102r and a second end 104r. The first end plate 100r further includes an upper surface 134r, a lower surface 132r, and an inner surface 130r connecting the first and second ends. As in all other aspects described herein, the upper surface comprises a surface mechanism that increases the roughness of the surface. The inner surface contains a cylindrical relief 149r whose axis is parallel to the major axis. The first end plate 100 further includes a first sloping surface 110r close to the first end and a second sloping surface 112r close to the second end. The slanted surfaces 110r and 112r further include dovetailed slanted slots 107r and 109r, respectively. As discussed above, in this embodiment the slots are dovetailed and have a substantially trapezoidal cross section, which are T-shaped, Y-shaped, or mating joints leading and trailing. It may have any other suitable cross section that allows it to possess both contact surfaces (trailing). The end plate 100r further includes an opening 119r that extends through the side surface in a longitudinal direction. Relief 149r. The edges formed by the intersections of the ramps 110r and 112r with the inner surface 130r include chamfers 121r and 123r configured to fit the insertion-deployment instrument 840p described above.

The lamp 300r is the same as the lamp 300p described above, with the following exceptions. The branches 321r and 323r do not have a U-shaped cross section like the corresponding mechanism of the lamp 300p, instead the branches 321r and 323r contain slanted surfaces 302r and 304r, respectively, while these slanted surfaces respectively. Includes dovetailed fins 302r1 and 304r1. The dovetail fins are configured to fit into the dovetail sloping slots on the end plate. The lamp 300r does not include the recessed slot present in the lamp 300p. The fourteenth deployable fusion device 1000r has the same functionality as the thirteenth deployable fusion device 1000p described above, including a dependency on the outer deploying instrument for width deployment.

Although various alternatives of the various components are presented herein as separate embodiments, these alternative embodiments have any mechanism that can be substituted or mixed / matched with any other aspect herein. Should also be understood. Also, if any of the above-mentioned alternative functions in any component is replaced and a mating component is needed to use the reverse or complementary form of those functions for proper engagement. And the shape of the reverse or complementary form inevitably arises from any alternative mechanism form described above and a detailed description of the embodiments described as utilizing that form. Please understand that it will be. As an example, the 14th deployable fusion device 1000r utilizes some or any of the actuator embodiments, height and width deployment mechanisms, configurations and embodiments, as well as end plate stabilizing mechanisms and aspects described herein. You may.

Fifteen Expandable Fusing Devices With reference to FIGS. 76A-76D, FIGS. 76A, 76B, 76C and 76D are end plates 100r, 150r, 200r and 250r (all identical in this embodiment), ramps 300s, 350s, 400s and An exemplary fifteenth expandable fusion comprising 450s (all identical in this embodiment), proximal wedge 550s, distal wedge 650s (distal and proximal wedges are identical in this embodiment) and actuator 500a. The initial folded state of the apparatus 1000s, the fully expanded state, the fully expanded state, and the three-dimensional exploded view are shown. The fifteenth deployable fusion device 1000s is identical to the fourteenth deployable fusion device 1000r described above, with the following exceptions. The proximal wedge 550s is identical to the proximal wedge 550a described above, with the following exceptions, and the upper and lower surfaces of the wedge 550s, unlike the wedge 550a, do not contain protrusions or channels and the wedge 550s. Opposing sloping surfaces of the wedge 550 have a larger sloping angle "A" between them. This angle is best shown in FIG. 76A and is intended to be greater than 100 degrees and less than 179 degrees, more preferably greater than 140 degrees and most preferably greater than 160 degrees (150 degrees angle is for illustration purposes). (Shown in). The lamp 300s is identical to the lamp 300r with the following exceptions: the surfaces 330s, 320s, and 329s are in the lamp 300r and are not perpendicular to the major axis, but the angle "A" discussed above. Tilt with respect to the major axis at an angle equal to half of "", which is most often seen in FIG. 76A. The ramp 300s further includes inclined undercuts 337s1 and 337s2, which are configured to fit into the deploying instrument and either rectangular or L-shaped, T-shaped or dovetailed. Can have. The end plates 100s are configured to fit with the deploying instrument and can have either a rectangular section or an L-shape, a T-shape or a dovetail section, with exceptions including the slanted undercuts 147s1 and 147s2. It is the same as the end plate 100r described above. When having a rectangular section, the undercuts 337s1, 337s2, 147s1 and 147s2 serve the purpose of preventing unfolding at the height of the device while the unfolding of the width is affected by the unfolding instrument. When these undercuts have an L-shape, dovetail, or similar section, reversing the direction of action serves the additional purpose of allowing the deploying instrument to both increase and decrease the width of the device. .. As discussed above, this is where sections such as L-shape, T-shape, dovetail, etc. embrace both front and back contact surfaces, capture mating components, and apply tension or compression to the interface. Because it can be done.

The importance and usefulness of the large included angle "A" between the slanted surfaces of the wedge is not clear and requires additional clarification. The functionality and clinical utility of many aspects of the deployable fusion devices described herein (eg, 1000a, 1000b, 1000c, 1000d, 1000e, etc.) are complete or clinically useful prior to the initiation of height deployment. It relies on the fact that a significant range of developments must occur. This is achieved by an end plate that continues sliding contact with the mating surface of the wedge during the width deployment step, and when configured by the method described above, this contact continues while the lamps are closer to each other. Prevent (necessary to affect height deployment). In the process of width unfolding, this contact between the end plate and the wedge is eventually lost, allowing height unfolding to begin. However, the fifteenth deployable fusion device 1000s does not include such a delay mechanism, and both width and height deployments appear to occur simultaneously by turning the actuator. An alternative fifteen expandable fusion device 1000s1 (not shown) that is identical to the fifteenth deployable fusion device 1000s, except that the angle "A" is relatively small (eg, about 90 degrees). Imagine this alternative fifteenth expandable fusion device 1000s1 in which the width of the device is completely smaller than the unfolded state and the height of the device is at least somewhat unfolded. When the actuator is kept stationary, normally inactive (ie, due to thread friction), and compression is applied to the end plate of a device such as an adjacent vertebral end plate applied for clinical use, The alternative fifteenth deployable fusion device 1000s1 first occurs until it reaches either full width unfolded or fully height folded (based on the initial spread of height and width unfolding). ), Folds in height and tends to expand in width at the same time. This is achievable at each position of the actuator with respect to the wedge and, as a result-each isolated distance between the proximal and distal wedges, in equipment conditions that have not yet reached full width deployment. This is because there is an expanded state of the range. In other words, in this situation, the alternative fifteenth deployable fusion device 1000s1 is not in equilibrium and its height deployment is "converted" to width deployment by the following mechanism of action: In such conditions, when height compression is applied to the end plates, the actuators remain stationary, so that the ramp components release them from the slanted surface involved in the height deployment. The ramps move only by sliding against the wedges, the larger width is unfolded, the distance between the ramps increases, and the height of the device only decreases. In a similar height-only or width-only deployment mechanism, friction at the actuator threads related to the "locking" characteristics of the threads used prevents reversal of this deployment. The locking thread is characterized by a small "spiral angle", for example, preventing the average screw from being pushed into an axially mating thread without applying any torque (with pure axial force). , The locking thread does not follow a spiral path into the mating thread.) This is in contrast to the non-locking (or overhaul) threads used in cork-threads, which are forced to be screwed into the workpiece by applying pure axial force. However, in this case, the locking characteristics of the actuator thread cannot prevent height loss because the actuator does not move and the non-equilibrium state is unique to the mechanism. Similar to a thread with a mechanical effect controlled by the angle of the thread's spiral (with a small spiral angle that gives the thread a locking characteristic), as well as a ramp or "tilted plane" (with wedge mechanism applied). It is known to possess a mechanical effect (or advantage), which is the length of the tilt expressed in its rise, or more simply-in the thread angle of the wedge. The larger the thread angle, the smaller the mechanical advantage of the wedge mechanism. In addition, any wedge mechanism and material used (and the friction generated) has a maximum thread angle, where when the wedge no longer acts as a wedge, it pushes the wedge between the two objects. No matter how large the frictional force, load, and load due to the strength of the material, these objects will not be forced to separate when attempted to squeeze.

Returning this to the fifteenth deployable fusion device 1000s, the proximal and distal wedges 550s and 650s utilize the high angle "A" so that they do not act as a width deployment mechanism and instead the fifteenth. The deployable fusion device 1000s voluntarily loses height and functions as a locking mechanism to prevent gaining width. This is rational that when the actuator 500 is turned in the initial folded state, the fifteenth deployable fusion device 1000s deploys only at height, does not deploy at width, and acts in the height direction. It means that the compressive force does not lose the height of the device and gains width as discussed above. The fifteenth deployable fusion device 1000s relies on the lateral insertion-deployment instrument 840s (as seen in FIGS. 77A and 77B) to influence the width deployment.

Insert-deployment instruments 840s (not shown in their entirety) are a set that are pulled together or forced apart using screwing, gripping, or any other mechanism (not shown). Includes a front wedge 840s1 and a set of rear wedges 840s2. The instrument 840s is configured to simultaneously actuate (turn here) the actuators in the forward or reverse direction, translating the front and rear wedges together or away. Turning the actuator in the width unfolding process does not cause or substantially contribute to the width unfolding itself (high angle "A" of the wedges and the resulting near zero mechanical effect of these wedges. (Because), only allowing the proximal and distal wedges to move towards each other provides room for the width deployment to be affected by the forces supplied by the instrument 840s. The insertion-deployment instrument engages the fifteenth expandable fusion device 1000s in the fully unfolded state of the device, after which the device is folded to its initial state for insertion into the disc space (FIG. 77A). Most often seen in). When inserted into the disc space, the anterior and posterior wedges of the instrument are pulled together and the fifteenth deployable fusion device 1000s prevents the anterior wedge from contacting the device 1000p (most commonly seen in FIG. 77B). State), and expand the width to the expanded width to be pulled out. When that happens, the height of the device is unfolded. This arrangement means that in order for the instrument 840s to be removed from the appliance 1000p, the width that allows the appliance to pull out the forward wedge must be fully unfolded. Optionally, in any embodiment, a plurality of different front wedge widths may be supplied to the end user so that the optimum target deployment width for the detailed application can be determined. Optionally, in any embodiment, a plurality of different front wedge widths can be supplied to the end user so that the optimal target deployment width for detailed application can be determined. Manipulating the width deployment with two opposing wedges is wider without the dovetails, hooks, L-shapes or other articulations used between the anterior and posterior wedges and in the device. It does not allow the instrument to decrease from state to narrower state, thereby allowing the instrument to exert both tension and compression on the device, thereby expanding and folding the width of the device as discussed above. Allow both of that.

Although various alternatives of the various components are presented herein as separate embodiments, these alternative embodiments have any mechanism that can be substituted or mixed / matched with any other aspect herein. Should also be understood. Also, replacing any of the aforementioned alternative functions in any component may require a mating component to use the reverse or complementary form of those functions for proper engagement. Or may be required, and vice versa or complementary shaped shapes are inevitable from the detailed description of any alternative mechanism form described above and the embodiments described as utilizing that shape. Please understand that it will happen. As an example, the fifteenth deployable fusion device 1000s includes actuator embodiments, height and width deployment mechanisms, configurations and embodiments, as well as end plate stabilizing mechanisms and embodiments described herein (eg, embodiments 1000c and 1000d). Some or any of (as shown in) may be utilized.

With reference to the 16th deployable fusion device FIGS. 78, 79A, and 79B, FIG. 78 shows the initial folded state of the deployable device 1000t, and FIG. 79A is an exemplary deployment instrument attached. The 16th deployable fusion device 1000t shows the initial folded state, and FIG. 79B shows the unfolded state of the width of the device 1000t to which the deploying instrument is attached. The 16th deployable fusion device 1000t includes end plates 100t, 150t (most commonly seen in FIG. 79B), 200t and 250t (these are all the same in this embodiment), lamps 300s, 350s, 400s and 450s (these are). Includes (all identical in this embodiment), proximal wedge 550s, distal wedge 650s (in this embodiment the distal wedge and proximal wedge are identical) and actuator 500a. The sixteenth deployable fusion device 1000t is identical to the device 1000s described above with the following exceptions. The end plate 100t includes an inclined slot 107t2 formed on the upper surface surface 134t. This tilted slot is configured to engage the insertion-deployment instrument 840t (most commonly seen in FIGS. 79A and 79B).

The insert-deployment instrument 840t (not shown in its entirety) is a set of forward branch ramps that are pushed or pulled while the instrument body (not shown) is mounted and bearing on a proximal wedge. Includes 840t1. The instrument 840t is configured to simultaneously actuate (here turn) the actuator in the forward or reverse direction and translate the branch ramp to forward or backward depending on the direction of actuation. Turning the actuator in the width unfolding process does not cause or substantially contribute to the width unfolding itself (high angle "A" of the wedges and the resulting near zero mechanical effect of these wedges. Because), only allowing the proximal and distal wedges to move towards each other provides room for the width deployment to be affected by the force delivered by the instrument 840t. The insertion-deployment instrument engages the 16th expandable fusion device 1000t in the fully unfolded state of the device, after which the device is folded to its initial state for insertion into the disc space (Figure). Most commonly seen in 79A). When inserted into the disc space, the instrument branch ramp is pulled towards the proximal end of the instrument, the body of the instrument is bearing against the proximal wedge, and at the same time the actuator turns. As a result, the 16th deployable fusion device 1000t expands in width to the deployment width at which the branch lamp does not come into contact with the 16th deployable fusion device 1000t (the state most clearly seen in FIG. 79B), and is pulled out. When that happens, the height of the device is unfolded. This arrangement means that in order for the instrument 840t to be removed from the 16th deployable fusion device 1000t, the width that allows the device to pull out the anterior wedge must be fully deployed. Optionally, in any embodiment, a plurality of different front wedge widths may be supplied to the end user so that the optimum target deployment width for the detailed application can be determined. The branch ramp of the instrument has both anterior and posterior contact surfaces with the end plate, so if the instrument is actuated in one direction and the width of the instrument expands, the width unfolding process is reversible and actuated. When reversing the direction, the device is folded in width.

17th Deployable Healing Device With reference to FIG. 80 here, FIG. 80 is exemplary, exemplary, the thirteenth deployable healing device 1000p described above, with certain exceptions described below. A diagram of the general width deployment functionality of the 17th deployable fusion device 1000u is shown. The seventeenth deployable fusion device 1000u is a variant of the thirteenth deployable fusion device 1000p, between the proximal wedge and its two mating lamps, and between the distal wedge and its two mating lamps. The substantially parallel articulated surface between them is tilted with respect to the vertical axis of the device and possesses the desirable property of allowing the device to unfold its width non-linearly, while the width of the device is unfolded. For example, instead of the rectangle produced by the thirteenth expandable fusion device 1000p, it is made to have the general shape of a parallelogram. This is useful for some surgical approaches where the approach axis is angled with respect to a standard anatomical plane, such as the transforaminal (or TLIF) approach.

Eighteen Expandable Healing Device FIGS. 81A-86 provided herein are an eighteenth deployable healing device 1000v for implantation between two adjacent vertebrae. Optionally, in any embodiment, the apparatus 1000v of FIG. 81A is: an actuator 500v including a drive mechanism 503v and a vertical axis 504v; a wedge assembly 750v coupled to the actuator 500v; a lamp assembly 800v slidably coupled to the wedge assembly 750v. Includes an upper end plate assembly 850v slidably coupled to the ramp assembly 800v; and a lower end plate assembly 900v slidably coupled to the ramp assembly 800v.

Optionally, in any embodiment, the apparatus 1000v of FIG. 81B has a width of 1100v including at least one outer width of the upper end plate assembly 850v and the lower end plate assembly 900v. Optionally, in any embodiment, the device has a height of 1200v including an external distance between the upper end plate assembly 800v and the lower end plate assembly 900v.

Optionally, in any embodiment, the actuation of the drive mechanism 503v by the first actuation number in the first actuation direction 1300v of FIG. 87C increases the width 1100v without increasing the height 1200v. Optionally, in any embodiment, the actuation of the drive mechanism 503v by a second actuation number exceeding the first actuation number in the first actuation direction 1300v increases at least one of height 1200v and width 1100v. Optionally, in any embodiment, the actuation of the drive mechanism 503v by a second actuation number exceeding the first actuation number in the first actuation direction 1300v increases both the height 1200v and the width 1100v, the first. The operation of the drive mechanism 503v by the third operation number exceeding the second operation number in the operation direction 1300v increases the height 1200v without increasing the width 1100v. Optionally, in any embodiment, the actuation of the drive mechanism 503v by a second actuation number exceeding the first actuation number in the first actuation direction 1300v does not increase the height 1200v or the width 1100v, and the first actuation. The operation of the third drive mechanism 503v, which exceeds the second number of operations in the direction 1300v, increases the height 1200v without increasing the width 1100v. Optionally, in any embodiment, when the drive mechanism 503v is actuated by at least the first actuation number, the width 1100v of the device 1000v reaches the limit. Optionally, in any embodiment, the height 1200v of the device 1000v reaches the limit when the drive mechanism 503v is actuated by at least the first and second actuation numbers.

Optionally, in any embodiment, the actuation of the drive mechanism 503v by a second actuation number exceeding the first actuation number in the first actuation direction 1300v increases both the height 1200v and the width 1100v. Optionally, in any embodiment, the actuation of the drive mechanism 503v by a second actuation number exceeding the first actuation number in the first actuation direction increases the height 1200v without increasing the width 1100v.

Optionally, in any embodiment, the actuation of the drive mechanism 503v in the first actuation direction 1300v by at least the first actuation number increases the height 1200v of the apparatus 1000v by about 30% to about 400%. Optionally, in any embodiment, the actuation of the drive mechanism 503v in the first actuation direction 1300v by at least the first and second actuation numbers increases the width 1100v of the apparatus 1200v by about 14% to about 150%.

Optionally, in any embodiment, the actuator 500v of FIG. 82 comprises a cylindrical elongated shaft with a distal end and a proximal end. Optionally, in any embodiment, at least a portion of the distal end comprises a first thread mechanism 501v. Optionally, in any embodiment, at least a portion of the proximal end comprises a second thread mechanism 502v and the proximal end comprises a drive mechanism 503v. Optionally, in any embodiment, at least one of the first thread mechanism 501v and the second thread mechanism 502v comprises a thread arranged outside the perimeter of the actuator 500v. Optionally, in any embodiment, the first thread mechanism 501v and the second thread mechanism 502v have opposite threading directions. Optionally, in any embodiment, the first thread mechanism 501v and the second thread mechanism 502v have the same threading direction. Optionally, in any embodiment, at least one of the first thread mechanism 501v and the second thread mechanism 502v comprises right-handed thread cutting. Optionally, in any embodiment, at least one of the first thread mechanism 501v and the second thread mechanism 502v comprises left-handed thread cutting. Optionally, in any embodiment, the drive mechanism 503v comprises a recessed region configured to receive the drive instrument. Optionally, in any embodiment, the recessed area is a slot, Philips, positive drive, Flairson, Robertson, 12-point flange, hex socket, security hex socket, star drive, Security Torx®, ta, three points. , Tri-wing, spanner head, clutch, one-way, double square, triple square, poly drive, spline drive, double hex, bristol, or pentalobe recess, or any combination thereof. Optionally, in any embodiment, the drive mechanism comprises a protubalance configured to extend from it and be coupled to the drive instrument. Optionally, in any embodiment, the protubalance comprises a hexagonal, hexarobula, or square protubalance, or any other shape of protubalance. Optionally, in any embodiment, the drive mechanism 503v coincides with the vertical axis 504v.

Optionally, in any embodiment, the wedge assembly of FIG. 81C comprises a distal wedge 650v and a proximal wedge 550v. Optionally, in any embodiment, the actuation of the drive mechanism in the first direction brings the distal wedge 650v and the proximal wedge 550v closer to each other. Optionally, in any embodiment, the distal wedge 650v of FIGS. 89A-B is an isosceles trapezoidal prism that includes a distal surface and a proximal end. Optionally, in any embodiment, the distal wedge 650v comprises a third thread mechanism 654v. Optionally, in any embodiment, the third thread mechanism 654v extends from the distal surface of the distal wedge 650v to the proximal surface of the distal wedge 650v. Optionally, in any embodiment, the distal wedge 650v further comprises one or more mechanisms configured for temporary attachment to the inserter tool. Optionally, in any embodiment, the third thread mechanism 654v is screwed into the second thread mechanism 502v of the actuator 500v. Optionally, in any embodiment, the distal wedge 650v further comprises a first slot 651v and a second slot 652v. Optionally, in any embodiment, the first slot 651v is an upper left first slot 651v, an upper right first slot 651v, a lower left first slot 651v, and a lower right first slot. Includes 651v. Optionally, in any embodiment, the upper left first slot 651v and the upper right first slot 651v, and the lower left first slot 651v and the lower right first slot 651v are distal wedges 650v. Has mirror plane symmetry with respect to the sagittal plane of. Optionally, in any embodiment, the first slot 651v on the upper left and the first slot 651v on the lower left, and the first slot 651v on the upper right and the first slot 651v on the lower right are distal wedges 650v. Has mirror symmetry with respect to the transverse plane of. Optionally, in any embodiment, the center (medial) of the first slot 651v on the upper left, the first slot 651v on the upper right, the first slot 651v on the lower left, and the first slot 651v on the lower right. ) The plane is oriented at an angle across the sagittal plane of the distal wedge 650v. Optionally, in any embodiment, at least one of the third thread mechanism 654v and the fourth thread mechanism 554v, respectively, of the distal wedge 650v and the proximal wedge 550v is a third first mechanism of the actuator 500v. Includes a thread locking mechanism configured to prevent operation of at least one of 501v and a second thread mechanism 502v in a direction opposite to the first working direction 1300v. Optionally, in any embodiment, the thread locking mechanism comprises a deformable insert, a deformable thread, a distorted thread, a flexible lip, or any combination thereof. Optionally, in any embodiment, the thread locking mechanism is configured to provide access to a third thread mechanism 654v or a fourth thread mechanism 554v and / or a pin, screw, and. Includes a bore within at least one of a distal wedge 650v and a proximal wedge 550v that is configured to accept inserts such as dowels, nuts, or any combination thereof to prevent actuation of the actuator 500v.

Optionally, in any embodiment, the second slot 652v is a second slot 652v on the upper left, a second slot 652v on the upper right, a second slot 652v on the lower left, and a second slot on the lower right. Includes 652v. Optionally, in any embodiment, the upper left second slot 652v and the upper right second slot 652v, and the lower left second slot 652v and the lower right second slot 652v are distal wedges 650v. Has mirror plane symmetry with respect to the sagittal plane of. Optionally, in any embodiment, the upper left second slot 652v and the lower left second slot 652v, and the upper right second slot 652v and lower right second slot 652v are distal wedges 650v. Has mirror symmetry with respect to the transverse plane of. Optionally, in any embodiment, the central planes of the upper left second slot 652v, the upper right second slot 652v, the lower left second slot 652v, and the lower right second slot 652v are distant. It is oriented at an angular position across the sagittal plane of the position wedge 650v.

Optionally, in any embodiment, the proximal wedge 550v of FIG. 83B has an isosceles trapezoidal prism shape that includes a distal surface and a proximal surface. Optionally, in any embodiment, the proximal wedge 550v comprises a fourth thread mechanism 554v. Optionally, in any embodiment, the fourth thread mechanism 554v extends from the distal plane of the proximal wedge 550v to the proximal plane of the proximal wedge 550v. Optionally, in any embodiment, the proximal wedge 550v further comprises one or more mechanisms configured for temporary attachment to the inserter tool. Optionally, in any embodiment, the fourth thread mechanism 554v is screwed into the first thread mechanism 501v of the actuator 500v. Optionally, in any embodiment, the third thread mechanism 654v comprises a thread placed internally within the distal wedge 650v. Optionally, in any embodiment, the fourth thread mechanism 554v comprises a thread placed internally within the proximal wedge 650v. Optionally, in any embodiment, the third thread mechanism 654v and the fourth thread mechanism 554v have opposite threading directions. Optionally, in any embodiment, the third thread mechanism 654v and the fourth thread mechanism 554v have the same threading direction. Optionally, in any embodiment, at least one of the third thread mechanism 654v and the fourth thread mechanism 554v comprises right-handed thread cutting. Optionally, in any embodiment, at least one of the third thread mechanism 654v and the fourth thread mechanism 554v comprises left-handed thread cutting.

Optionally, in any embodiment, the lamp assembly 800v of FIG. 81C includes a first proximal lamp 300v, a second proximal lamp 400v, a first distal lamp 350v, and a second distal lamp 450v. ..

Optionally, in any embodiment, the second distal lamp 400v of FIGS. 84A and 84B comprises a rectangular prism divided into two lobes. Optionally, in any embodiment, the second distal lamp 400v is a first ridge 401v, a first protrusion 402v, a v-slot 403v, a third protrusion 404v, a third ridge 405v, and a third. Includes slot 406v. Optionally, in any embodiment, the first ridge 401v comprises two first ridges 401v. Optionally, in any embodiment, the first ridge 401v is located on the proximal end of the second distal lamp 400v. Optionally, in any embodiment, the central plane of the first ridge 401v is at a turning angle from the central plane of the second distal lamp 400v. Optionally, in any embodiment, the first protrusion 402v comprises two first protrusions 402v. Optionally, in any embodiment, the first projection 402v is located on the mesial proximal corner of the second distal lamp 400v. Optionally, in any embodiment, the v-slot 403v comprises two v-slots 403v. Optionally, in any embodiment, the v-slot 403v is located on the mesial plane of the second distal lamp 400v. Optionally, in any embodiment, the limit of v-slot 403v is oriented towards the distal end of the second distal lamp 400v. Optionally, in any embodiment, the protrusion 404v comprises two protrusions 404v. Optionally, in any embodiment, the protrusion 404v is located on the lower surface of the distal lamp 400v. Optionally, in any embodiment, the third ridge 405v comprises two third ridges 405v. Optionally, in any embodiment, the third ridge 405v is located on the upper surface of the second distal lamp 400v. Optionally, in any embodiment, the central plane of the third ridge 405v is parallel to the mesial plane of the second distal lamp 400v. Optionally, in any embodiment, the third slot 406v comprises two third slots 406v, including two two third slots 406v. Optionally, in any embodiment, the third slot 406v is located on the upper surface of the second distal lamp 400v. Optionally, in any embodiment, the central plane of the third slot 406v is parallel to the mesial plane of the distal lamp 400v. Optionally, in any embodiment, the first distal lamp 300v is mirror-equivalent to the second distal lamp 400v. Optionally, in any embodiment, the first distal lamp 350v comprises a second ridge 351v. Optionally, in any embodiment, the second ridge 351v comprises two second ridges 351v. Optionally, in any embodiment, the second ridge 351v is located on the lateral flank of the first distal lamp 350v. Optionally, in any embodiment, the first distal lamp 350v comprises a second projection 352v. Optionally, in any embodiment, the second protrusion 352v comprises two second protrusions 352v. Optionally, in any embodiment, the second projection 352v is located on the lateral proximal end of the first distal lamp 350v. Optionally, in any embodiment, the central plane of the second protrusion 352v is perpendicular to the central plane of the second ridge 351v. Optionally, in any embodiment, the first distal lamp 350v comprises a tongue 353v. Optionally, in any embodiment, the tongue portion 353v extends from the bottom of the distal lamp 350v to the top of the distal lamp 350v along the lateral proximal edge of the distal lamp 350v. Optionally, in any embodiment, the second distal lamp 450v is mirror-equivalent to the first distal lamp 350v. Optionally, in any embodiment, the upper end plate assembly comprises a first end plate 100v and a second end plate 250v. Optionally, in any embodiment, the lower end plate assembly comprises a third end plate 150v and a fourth end plate 200v.

Optionally, in any embodiment, a first end plate 100v and a second end plate 250v, a third end plate 150v and a fourth end plate 200v, a first proximal lamp 300v and a second proximal lamp. 400v, and at least one of the first distal lamp 350v and the second distal lamp 450v have mirror equivalence. Optionally, in any embodiment, at least one of the second end plate 250v and the fourth end plate 200v is greater than at least one of the first end plate 100v and the third end plate 150v. Optionally, in any embodiment, at least one of the outer surfaces of the first end plate 100v, the second end plate 250v, the third end plate 150v, and the fourth end plate 200v so as to grip the vertebrae. Includes constituent textures. Optionally, in any embodiment, the texture ring comprises teeth, ridges, rough surface areas, metal coatings, ceramic coatings, keels, spikes, protrusions, grooves, or any combination thereof.

Optionally, in any embodiment, slideable between at least one of the wedge assembly 750v and the ramp assembly 800v, the ramp assembly 800v and the upper end plate assembly 850v, and the ramp assembly 800v and the lower end plate assembly 900v of FIGS. 81A and 81C. The connection is at an angular position across the vertical axis 504v. Optionally, in any embodiment, the crossing angle is from about 0 ° to about 90 °.

Optionally, in any embodiment, a slidable connection between at least one of the wedge assembly 750v and the ramp assembly 800v, the ramp assembly 800v and the upper end plate assembly 850v, and the ramp assembly 800v and the lower end plate assembly 900v is a protrusion and Includes slots. Optionally, in any embodiment, the protrusions extend from at least one of a wedge assembly 750v, a ramp assembly 800v, an upper end plate assembly 850v, and a lower end plate assembly 900v. Optionally, in any embodiment, the slot is located in at least one of a wedge assembly 750v, a ramp assembly 800v, an upper end plate assembly 850v, and a lower end plate assembly 900v. Optionally, in any embodiment, the protrusion comprises a pin 600, a ridge, a dimple, a bolt, a screw, a bearing, or any combination thereof. Optionally, in any embodiment, the slot comprises a through slot, a blind slot, a t-slot, a v-slot, a groove, or any combination thereof.

Optionally, in any embodiment, the slidable connection between the wedge assembly 750v and the ramp assembly 800v of FIGS. 81A-86B is a first slot 651v and a second slot 652v, proximal within the distal wedge 650v. 3rd slot 551v and 4th slot 552v in wedge 550v, 1st protrusion 402v and 1st ridge 401v in 2nd proximal lamp 300v and 2nd proximal lamp 400v, 1st distal Includes a second protrusion 352v, a second ridge 351v, and a tongue 353v within the ramp 350v and the second distal ramp 450v. Optionally, in any embodiment, a first slot 651v, a second slot 652v, a third slot 551v, a fourth slot 552v, a first protrusion 402v, a first ridge 401v, a second protrusion 352v, And at least one number of second ridges 351v is about 1, 2, 3, 4 or more.

Optionally, in any embodiment, the slidable connection between the proximal wedge 550v and the first proximal lamp 300v or the second proximal lamp 400v is with a third slot 551v and a first ridge 401v. Includes a slideable connection between, and a slideable connection between the fourth slot 552v and the first projection 402v.

Optionally, in any embodiment, the slidable connection between the distal wedge 650v and the first distal lamp 350v or the second distal lamp 450v is with a first slot 651v and a second ridge 351v. Includes a slidable connection between, a slidable connection between the second slot 652v and the second projection 352v, or any combination thereof.

Optionally, in any embodiment, the second slot 652v within the distal wedge 650v comprises a first stop 653v to prevent the first protrusion 402v from exiting the second slot 652v in one direction. .. Optionally, in any embodiment, the fourth slot 552v within the proximal wedge 550v includes a second stop 553v to prevent the first protrusion 402v from exiting the second slot 652v in one direction. ..

Optionally, in any embodiment, the slidable connection between the lamp assembly 800v and the upper end plate assembly 850v or the lower end plate assembly 900v is at least the first distal lamp 350 and the second distal lamp 450. A tongue 353v within one, and a third within at least one of v-slot 403v, a third protrusion 404v, a third ridge 405v, and a first proximal lamp 300 and a second proximal lamp 400. Slot 406v, and dovetail slot 101v, fourth projection 102v, within at least one of the first end plate 100v, the second end plate 250v, the third end plate 150v, and the fourth end plate 200v. It includes a fourth slot 104v, a fifth slot 103v and a fourth ridge 105v.

Optionally, in any embodiment, a first distal lamp 350v or a second distal lamp 450v and a first end plate 100v, a second end plate 250v, a third end plate 150v, or a fourth. The slidable connection between the end plate 200v includes a slidable connection between the dovetail slot 101v and the tongue 353v.

Optionally, in any embodiment, a first proximal lamp 300v or a second proximal lamp 400v and a first end plate 100v, a second end plate 250v, a third end plate 150v, or a fourth. The slidable connection between the end plate 200v is a slidable connection between the v-slot 403v and the fourth projection 102v, a sliding connection between the third projection 404v and the fourth slot 104v. , Sliding connection between the third ridge 405v and the fifth slot 103v, sliding connection between the third slot 406v and the fourth ridge 105v, or any combination thereof.

Optionally, in any embodiment, the fourth projection 102v comprises the mechanism of a first end plate 100v, a second end plate 250v, a third end plate 150v, or a fourth end plate 200v. Optionally, in any embodiment, the fourth projection 102v is firmly inserted into a first end plate 100v, a second end plate 250v, a third end plate 150v, or a fourth end plate 200v. Includes components that have been Optionally, in any embodiment, the fourth projection 102v comprises a pin 600v.

Optionally, in any embodiment, the slidable connection between the wedge assembly 750v and at least one of the upper end plate assembly 850v and the lower end plate assembly 900v is a first end plate 100v, a second end plate 250v, With the distal chamfer 123v and the proximal chamfer 121v in at least one of the third end plate 150v and the fourth end plate 200v and the guide surface 621v and 521v in at least one of the distal wedge 650v and the proximal wedge 550v. Includes a slideable connection between. Optionally, in any embodiment, the slidable connection between the wedge assembly 750v and at least one of the upper end plate assembly 850v and the lower end plate assembly 900v is until the 1000v width of the device reaches its limit of 1100v. Prevents the height of the device from increasing by 1200v.

Optionally, in any embodiment, at least one of the actuator 500v, wedge assembly 750v, lamp assembly 8000v, upper end plate assembly 850v and lower end plate assembly 900v is titanium, cobalt, stainless steel, tantalum, platinum, PEEK, PEKK. , Carbon fiber, barium sulfate, hydroxyapatite, ceramic, zirconium oxide, silicon nitride, carbon, bone graft, desalted bone matrix products, synthetic bone substitutes, bone forming agents, bone growth-inducing materials or any combination thereof. ..

FIG. 81A provided herein is a deployable fusion system for implantation between two adjacent vertebrae, the system including a folding tool 5000v and an 18th expandable fusion device 1000v. Optionally, in any embodiment, when the actuator 500v is actuated by at least the first and second actuation numbers in the first actuation direction 1300v such that the width 1100v and height 1200v of the apparatus 1000v are extreme. Actuating the actuator 500v in the direction opposite to the working direction 1300v of 1 may reduce only the width 1100v without reducing the height 1200v of the device 1000v. Optionally, in any embodiment, a folding tool 5000v may be employed to allow a decrease in height of 1200v without reducing the width of 1100v. Optionally, in any embodiment, the folding tool 5000v comprises a first branch 5001v and a second branch 5001v, the first branch 5001v is a proximal wedge 550v and / or a distal wedge 650v and a first near. It is configured to be inserted between the position ramp 300v and the second branch 5002v is inserted between the proximal wedge 550v and / or the distal wedge 650v and the second proximal ramp 400v. It is composed. Optionally, in any embodiment, the first branch 5001v and the second branch 5001v have the same length. Optionally, in any embodiment, the first branch 5001v and the second branch 5001v have different lengths. Optionally, in any embodiment, the first branch 5001v and the second branch 5001v have the same thickness. Optionally, in any embodiment, the first branch 5001v and the second branch 5001v have different thicknesses.

Optionally, in any embodiment, the eighteenth deployable fusion device 1000v may further or alternatively include any mechanism, component, or feature of any of the previously described deployable fusion devices.

Numerical indicators of the 18th exemplary deployable fusion device components are summarized in Table 1 below.

19th Deployable Healing Device FIGS. 87A-94D provided herein are 19th deployable healing devices 1000w for implantation between two adjacent vertebrae. Optionally, in any embodiment, the apparatus 1000w of FIG. 81A is: an actuator 500w including a drive mechanism 503w and a vertical axis 504w; a wedge assembly 750w coupled to the actuator 500v; a lamp assembly 800w slidably coupled to the wedge assembly 750v. Includes an upper end plate assembly 850w slidably coupled to the lamp assembly 800v; and a lower end plate assembly 900w slidably coupled to the ramp assembly 800w. Optionally, in any embodiment, the upper end plate assembly 850w is further slidably coupled to the lower end plate assembly 900w.

Optionally, in any embodiment, the device 1000w of FIG. 87A has a width of 1100w including at least one outer width of the upper end plate assembly 850w and the lower end plate assembly 900w. Optionally, in any embodiment, the device has a height of 1200 w, including an external distance between the upper end plate assembly 800w and the lower end plate assembly 900w.

Optionally, in any embodiment, the actuation of the drive mechanism 503w by the first actuation number in the first actuation direction 1300w of FIG. 87C increases the width 1100w without increasing the height 1200w. Optionally, in any embodiment, the actuation of the drive mechanism 503w with a second actuation number exceeding the first actuation number in the first actuation direction 1300w increases the width 1100w without increasing the height 1200w. Optionally, in any embodiment, the actuation of the drive mechanism 503w with a second actuation number exceeding the first actuation number in the first actuation direction 1300w increases both the height 1200w and the width 1100w, the first. The operation of the drive mechanism 503w by the third operation number exceeding the second operation number in the operation direction 1300w increases the height 1200w without increasing the width 1100v. Optionally, in any embodiment, the actuation of the drive mechanism 503w by a second actuation number exceeding the first actuation number in the first actuation direction 1300w does not increase the height 1200w or the width 1100w, and the first actuation. The operation of the third drive mechanism 503w, which exceeds the second number of operations in the direction 1300w, increases the height 1200w without increasing the width 1100w. Optionally, in any embodiment, when the drive mechanism 503w is actuated by at least the first actuation number, the width 1100w of the device 1000w reaches the limit. Optionally, in any embodiment, the height 1200w of the device 1000w reaches the limit when the drive mechanism 503w is actuated by at least the first and second actuation numbers.

Optionally, in any embodiment, the actuation of the drive mechanism 503w with a second actuation number exceeding the first actuation number in the first actuation direction 1300w increases both the height 1200w and the width 1100w. Optionally, in any embodiment, the actuation of the drive mechanism 503w with a second actuation number exceeding the first actuation number in the first actuation direction increases the height 1200w without increasing the width 1100w.

Optionally, in any embodiment, the actuation of the drive mechanism 503w in the first actuation direction 1300w by at least the first actuation number increases the height 1200w of the device 1000w by about 30% to about 400%. Optionally, in any embodiment, the actuation of the drive mechanism 503w in the first actuation direction 1300w by at least the first and second actuation numbers increases the width 1100w of the device 1200w by about 14% to about 150%.

Optionally, in any embodiment, the actuator 500w of FIG. 88 comprises a cylindrical elongated shaft with a distal end and a proximal end. Optionally, in any embodiment, at least a portion of the distal end of the actuator 500w comprises a first thread mechanism 501w. Optionally, in any embodiment, at least a portion of the proximal end of the actuator 500w comprises a second thread mechanism 502w and the proximal end comprises a drive mechanism 503w. Optionally, in any embodiment, at least one of the first thread mechanism 501w and the second thread mechanism 502w includes threads arranged outside the perimeter of the actuator 500w. Optionally, in any embodiment, the first thread mechanism 501w and the second thread mechanism 502w have opposite threading directions. Optionally, in any embodiment, the first thread mechanism 501w and the second thread mechanism 502w have the same threading direction. Optionally, in any embodiment, at least one of the first thread mechanism 501w and the second thread mechanism 502w comprises right-handed thread cutting. Optionally, in any embodiment, at least one of the first thread mechanism 501w and the second thread mechanism 502w comprises a left-handed threading. Optionally, in any embodiment, the drive mechanism 503w includes a recessed region configured to receive the drive instrument. Optionally, in any embodiment, the recessed area is a slot, Philips, positive drive, Flairson, Robertson, 12-point flange, hex socket, security hex socket, star drive, Security Torx®, ta, three points. Includes, three wings, spanner head, clutch, one way, double square, triple square, polydrive, spline drive, double hex, bristol, or pentalobe recess. Optionally, in any embodiment, the drive mechanism comprises a protubalance configured to extend from it and be coupled to the drive instrument. Optionally, in any embodiment, the protubalance comprises a hexagonal, hexarobula, or square protubalance. Optionally, in any embodiment, the drive mechanism 503w coincides with the vertical axis 504w.

Optionally, in any embodiment, the wedge assembly of FIG. 87C comprises a distal wedge 650w and a proximal wedge 550w. Optionally, in any embodiment, the actuation of the drive mechanism in the first direction brings the distal wedge 650w and the proximal wedge 550w closer to each other. Optionally, in any embodiment, the distal wedge 650w of FIGS. 89A-B is a crescent-shaped prism including the distal end, the proximal end, the top side, and the bottom side. Optionally, in any embodiment, the distal wedge 650w comprises a third thread mechanism 654w. Optionally, in any embodiment, the third thread mechanism 654w extends from the distal end of the distal wedge 650w to the proximal end of the distal wedge 650w. Optionally, in any embodiment, the distal wedge 650w further comprises one or more mechanisms configured for temporary attachment to the inserter tool. Optionally, in any embodiment, the third thread mechanism 654w is screwed into the second thread mechanism 502w of the actuator 500w. Optionally, in any embodiment, the distal wedge 650w further comprises a first slot 651w and a second slot 652w. Optionally, in any embodiment, the first slot 651w is an upper left first slot 651w, an upper right first slot 651w, a lower left first slot 651w, and a lower right first slot. Includes 651w. Optionally, in any embodiment, the first slot 651w on the upper left and the first slot 651w on the lower left, and the first slot 651w on the upper right and the first slot 651w on the lower right are distal wedges 650w. Has mirror symmetry with respect to the transverse plane of. Optionally, in any embodiment, the central planes of the first slot 651w on the upper left, the first slot 651w on the upper right, the first slot 651w on the lower left, and the first slot 651w on the lower right , Directed at an angular position across the sagittal plane of the distal wedge 650w. Optionally, in any embodiment, the second slot 652w is a second slot 652w on the upper left, a second slot 652w on the upper right, a second slot 652w on the lower left, and a second slot on the lower right. Includes 652w. Optionally, in any embodiment, the upper left second slot 652w and the lower left second slot 652w, and the upper right second slot 652w and the lower right second slot 652w are distal wedges 650w. Has mirror symmetry with respect to the transverse plane of. Optionally, in any embodiment, the central planes of the upper left second slot 652w, the upper right second slot 652w, the lower left second slot 652w, and the lower right second slot 652w are distant. It is oriented at an angular position across the sagittal plane of the position wedge 650w. Optionally, in any embodiment, the proximal wedge 550w is equivalent to the distal wedge 650w. Optionally, in any embodiment, the sagittal plane of the distal wedge 650w of FIG. 87C is arranged to be coplanar with the sagittal plane of the proximal wedge 550w. Optionally, in any embodiment, the sagittal plane of the distal wedge 650w of FIG. 87C is arranged to be arranged 180 ° from the sagittal plane of the proximal wedge 550w.

Optionally, in any embodiment, at least one of the third thread mechanism 654w and the fourth thread mechanism 554w, respectively, of the distal wedge 650w and the proximal wedge 550w is a third first mechanism of the actuator 500w. Includes a thread locking mechanism configured to prevent operation of at least one of 501w and a second thread mechanism 502w in a direction opposite to the first working direction 1300w. Optionally, in any embodiment, the thread locking mechanism comprises a deformable insert, a deformable thread, a distorted thread, a flexible lip, or any combination thereof. Optionally, in any embodiment, the thread locking mechanism is configured to provide access to a third thread mechanism 654w or a fourth thread mechanism 554w and / or a pin, screw, and. Includes a bore within at least one of a distal wedge 650w and a proximal wedge 550w that is configured to accept inserts such as dowels, nuts, or any combination thereof to prevent actuation of the actuator 500w. Optionally, in any embodiment, the lamp assembly 800w of FIG. 87C includes a first proximal lamp 300w, a second proximal lamp 400w, a first distal lamp 350w, and a second distal lamp 450w. ..

Optionally, in any embodiment, the second proximal lamp 400w of FIGS. 90A and 90B comprises a substantially triangular prism. Optionally, in any embodiment, the second proximal lamp 400w is a first ridge 401w, a first protrusion 402w, a v-slot 403w, a third protrusion 404w, a third ridge 405w, and a third. Includes slot 406w. Optionally, in any embodiment, the first ridge 401w comprises two first ridges 401w. Optionally, in any embodiment, the central plane of the first ridge 401w is at a turning angle from the central plane of the second proximal lamp 400w. Optionally, in any embodiment, the first protrusion 402w comprises two first protrusions 402w. Optionally, in any embodiment, the v-slot 403w is located on the transverse plane of the second proximal lamp 400w. Optionally, in any embodiment, the limit of v-slot 403w is oriented towards the mesial plane of device 1000w. Optionally, in any embodiment, the protrusion 404w comprises two protrusions 404w. Optionally, in any embodiment, the protrusion 404w is located on the lower surface of the distal lamp 400w. Optionally, in any embodiment, the third ridge 405w comprises two third ridges 405w. Optionally, in any embodiment, the third ridge 405w is located on the lower surface of the second proximal lamp 400w. Optionally, in any embodiment, the central plane of the third ridge 405w is parallel to the mesial plane of the second proximal lamp 400w. Optionally, in any embodiment, the third slot 406w comprises two third slots 406w, including two two third slots 406w. Optionally, in any embodiment, the third slot 406w is located on the upper surface of the second proximal lamp 400w. Optionally, in any embodiment, the central plane of the third slot 406w is parallel to the mesial plane of the distal lamp 400w. Optionally, in any embodiment, the second proximal lamp 300w is equivalent to the first distal lamp 350w.

Optionally, in any embodiment, the first proximal lamp 300w of FIGS. 91A and 91B comprises a substantially triangular prism. Optionally, in any embodiment, the second distal lamp 300w is a first ridge 301w, a first protrusion 302w, a v-slot 303w, a third protrusion 304w, a third ridge 305w, and a third. Includes slot 306w. Optionally, in any embodiment, the first ridge 301w comprises two first ridges 301w. Optionally, in any embodiment, the central plane of the first ridge 301w is at a turning angle from the central plane of the second distal lamp 300w. Optionally, in any embodiment, the first protrusion 302w comprises two first protrusions 302w. Optionally, in any embodiment, the v-slot 303w is located in the cross section of the second distal lamp 300w. Optionally, in any embodiment, the limit of the v-slot 303w is oriented towards the mesial plane of the device 1000w. Optionally, in any embodiment, the protrusion 304w comprises two protrusions 304w. Optionally, in any embodiment, the protrusion 304w is located on the lower surface of the distal lamp 300w. Optionally, in any embodiment, the third ridge 305w comprises two third ridges 305w. Optionally, in any embodiment, the third ridge 305w is located on the lower surface of the second distal lamp 300w. Optionally, in any embodiment, the central plane of the third ridge 305w is parallel to the mesial plane of the second distal lamp 300w. Optionally, in any embodiment, the third slot 306w includes two third slots 306w, including two two third slots 306w. Optionally, in any embodiment, the third slot 306w is located on the upper surface of the second distal lamp 300w. Optionally, in any embodiment, the central plane of the third slot 306w is parallel to the mesial plane of the distal lamp 300w. Optionally, in any embodiment, the first proximal lamp 300w is equivalent to the second distal lamp 450w.

Optionally, in any embodiment, the upper end plate assembly comprises a first end plate 100w and a second end plate 250w. Optionally, in any embodiment, the lower end plate assembly comprises a third end plate 150w and a fourth end plate 200w.

Optionally, in any embodiment, a first end plate 100w and a second end plate 250w, a third end plate 150w and a fourth end plate 200w, a first proximal lamp 300w and a second proximal lamp. 400w, and at least one of the first distal lamp 350w and the second distal lamp 450w have mirror equivalence. Optionally, in any embodiment, at least one of the second end plate 250w and the fourth end plate 200w is larger than at least one of the first end plate 100w and the third end plate 150w. Optionally, in any embodiment, at least one of the outer surfaces of the first end plate 100w, the second end plate 250w, the third end plate 150w, and the fourth end plate 200w so as to grip the vertebrae. Includes constructed textures. Optionally, in any embodiment, the texture ring comprises teeth, ridges, rough surface areas, metal coatings, ceramic coatings, keels, spikes, protrusions, grooves, or any combination thereof.

Optionally, in any embodiment, slidable between at least one of the wedge assembly 750w and the lamp assembly 800w, the lamp assembly 800w and the upper end plate assembly 850w, and the lamp assembly 800w and the lower end plate assembly 900w of FIGS. 87A and 87C. The connection is at an angular position across the vertical axis 504w. Optionally, in any embodiment, the crossing angle is from about 0 ° to about 9 °.

Optionally, in any embodiment, the slidable connection between the wedge assembly 750w and the ramp assembly 800w, the ramp assembly 800w and the upper end plate assembly 850w, and the lamp assembly 800w and the lower end plate assembly 900w is a protrusion and Includes slots. Optionally, in any embodiment, the protrusions extend from at least one of a wedge assembly 750w, a lamp assembly 800w, an upper end plate assembly 850w, and a lower end plate assembly 900w. Optionally, in any embodiment, the slots are arranged in at least one of a wedge assembly 750w, a ramp assembly 800w, an upper end plate assembly 850w, and a lower end plate assembly 900w. Optionally, in any embodiment, the protrusion comprises a pin 600, a ridge, a dimple, a bolt, a screw, a bearing, or any combination thereof. Optionally, in any embodiment, the slot comprises a through slot, a blind slot, a t-slot, a v-slot, a groove or any combination thereof.

Optionally, in any embodiment, the slidable connection between the wedge assembly 750w and the lamp assembly 800w of FIGS. 87A-95B is a first slot 651w and a second slot 652w, proximal within the distal wedge 650w. A third slot 551w and a fourth slot 552w in a wedge 550w, a first protrusion 402w and a first ridge 401w in a first proximal lamp 300w and a second proximal lamp 400w, and a first distance. Includes a second projection 352w, a second ridge 351w and a v-slot 353w within the position lamp 350w and the second distal lamp 450w. Optionally, in any embodiment, a first slot 651w, a second slot 652w, a third slot 551w, a fourth slot 552w, a first protrusion 402w, a first ridge 401w, a second protrusion 352w, And at least one number of second ridges 351w is about 1, 2, 3, 4 or more.

Optionally, in any embodiment, the slidable connection between the proximal wedge 550w and the first proximal lamp 300w or the second proximal lamp 400w is with a third slot 551w and a first ridge 401w. Includes a slidable connection between, and a slideable connection between the fourth slot 552w and the first projection 402w.

Optionally, in any embodiment, the slidable connection between the distal wedge 650w and the first distal lamp 350w or the second distal lamp 450w is with the first slot 651w and the second ridge 351w. Includes a slidable connection between, a slidable connection between the slot 652w and the second projection 352w, or any combination thereof.

Optionally, in any embodiment, the second slot 652w within the distal wedge 650w includes a first stop 653w that prevents the first protrusion 402w from exiting the second slot 652w in one direction. Optionally, in any embodiment, the fourth slot 552w within the proximal wedge 550w includes a second stop 553w that prevents the first protrusion 402w from exiting the second slot 652w in one direction.

Optionally, in any embodiment, the slidable connection between the lamp assembly 800w and the upper end plate assembly 850w or the lower end plate assembly 900w is at least the first distal lamp 350 and the second distal lamp 450. A tongue 353w in one, a v-slot 403w, a third protrusion 404w, a third ridge 405w, and a third in at least one of the first proximal lamp 300 and the second proximal lamp 400. Slots 406w, as well as dovetail slots 101w, 151w, 201w, 251w, fourth protrusions 102w, 152w, 202w, 252w, fifth slots 103w, 153w, 203w, 253w, fourth slots 104w, 154w, 204w. , 254w, and the fourth ridge 105w, 155w, 205w, 255w in at least one of the first end plate 100w, the second end plate 250w, the third end plate 150w and the fourth end plate 200w. include.

Optionally, in any embodiment, a first distal lamp 350w or a second distal lamp 450w and a first end plate 100w, a second end plate 250w, a third end plate 150w, or a fourth. The slidable connection between the end plate 200w includes a slidable connection between the dovetail slots 101w, 151w, 201w, 251w and the tongue 353w.

Optionally, in any embodiment, a first proximal lamp 300w or a second proximal lamp 400w and a first end plate 100w, a second end plate 250w, a third end plate 150w, or a fourth. The slidable connection between the end plate 200w is a slidable connection between the v-slot 403w and the fourth projections 102w, 152w, 202w, 252w, the third projection 404w and the fourth slot 104w, Sliding connection between 154w, 204w, 254w, third ridge 405w and fifth slot 103w, 153w, 203w, 253w, third slot 406w and fourth ridge 105w, 155w, 205w, 255w. Includes a slidable connection between, or any combination thereof.

Optionally, in any embodiment, the fourth protrusions 102w, 152w, 202w, 252w are of the first end plate 100w, the second end plate 250w, the third end plate 150w, or the fourth end plate 200w. Including the mechanism. Optionally, in any embodiment, the fourth protrusions 102w, 152w, 202w, 252w are on the first end plate 100w, the second end plate 250w, the third end plate 150w, or the fourth end plate 200w. Includes isolated components that are firmly inserted. Optionally, in any embodiment, the fourth protrusions 102w, 152w, 202w, 252w include a pin 600w.

Optionally, in any embodiment, the slidable connection between the upper end plate assembly 850w and the lower end plate assembly 900w is with the tongue portion 101w in the first end plate 100w and the groove 151w in the third end plate 150w. Includes a slidable connection between the tongue portion 251w at the second end plate 250w and the groove 201w at the fourth end plate 200w.

Optionally, in any embodiment, the slidable connection between the wedge assembly 750w and at least one of the upper end plate assembly 850w and the lower end plate assembly 900w is a first end plate 100w, a second end plate 250w. , A slidable connection between the distal chamfer 123w and the proximal chamfer 121w in at least one of the third end plate 150w, and the fourth end plate 200w, and at least the distal wedge 650w and the proximal wedge 550w. Includes guide surfaces 621w and 521w in one. Optionally, in any embodiment, the slidable connection between the wedge assembly 750w and at least one of the upper end plate assembly 850w and the lower end plate assembly 900w is until the 1000w width of the device reaches its limit of 1100w. Prevents the height of the device from increasing by 1200w.

Optionally, in any embodiment, at least one of the actuator 500w, wedge assembly 750w, lamp assembly 8000w, upper end plate assembly 850w, and lower end plate assembly 900w is titanium, cobalt, stainless steel, tantalum, platinum, PEEK, PEKK, carbon fiber, barium sulfate, hydroxyapatite, ceramics, zirconium oxide, silicon nitride, carbon, bone grafts, desalted bone matrix products, synthetic bone substitutes, bone forming agents, bone growth-inducing materials or any combination thereof. include.

Optionally, in any embodiment, the 19th deployable fusion device 1000W may further or alternatively include any mechanism, component, or feature of any of the previously described deployable fusion devices.

Further, FIGS. 96A-97 provided herein are deployable fusion systems for implantation between two adjacent vertebrae, the system being a folding tool 5000w and a 19th deployable fusion device. Includes 1000v. Optionally, in any embodiment, the actuator 500w is actuated by at least the first and second actuations in the first actuation direction 1300w such that the width 1100w and height 1200w of the apparatus 1000w are at their limits. The operation of the actuator 500w in the direction opposite to the first operating direction 1300w may reduce only the width 1100w without reducing the height 1200w of the device 1000v. Optionally, in any embodiment, a folding tool 5000w may be employed to allow a reduction in height of 1200w without reducing the width of 1100w. Optionally, in any embodiment, the folding tool 5000w comprises a first branch 5001w and a second branch 5001w, the first branch 5001w with a proximal wedge 550w and / or a distal wedge 650w and a first. It is configured to be inserted between the proximal ramp 300w and the second branch 5002w is inserted between the proximal wedge 550w and / or the distal wedge 650w and the second proximal ramp 400w. It is configured as follows. Optionally, in any embodiment, the first branch 5001w and the second branch 5001w have the same length. Optionally, in any embodiment, the first branch 5001w and the second branch 5001w have different lengths. Optionally, in any embodiment, the first branch 5001w and the second branch 5001w have the same thickness. Optionally, in any embodiment, the first branch 5001w and the second branch 5001w have different thicknesses.

Numerical indicators of the exemplary 19th deployable fusion device component are summarized in Table 2 below.

20th Deployable Healing Device FIGS. 98A-B provided herein are 20th deployable healing devices 1000x for implantation between two adjacent vertebrae. Optionally, in any embodiment, the apparatus 1000x of FIG. 95a is: an actuator 500x including a drive mechanism 503x and a vertical axis 504x; a wedge assembly 750x coupled to the actuator 500x; a lamp assembly 800x slidably coupled to the wedge assembly 750x. Includes an upper end plate assembly 850x slidably coupled to the lamp assembly 800x; and a lower end plate assembly 900x slidably coupled to the ramp assembly 800w.

Optionally, in any embodiment, at least one of the actuator 500w, wedge assembly 750x, lamp assembly 8000x, upper end plate assembly 850x, and lower end plate assembly 900x is titanium, cobalt, stainless steel, tantalum, platinum, PEEK. PEKK, carbon fiber, barium sulfate, hydroxyapatite, ceramics, zirconium oxide, silicon nitride, carbon, bone grafts, desalted bone matrix products, synthetic bone substitutes, bone forming agents, bone growth-inducing materials or any combination thereof. include.

Optionally, in any embodiment, the twentieth deployable fusion device 1000x can further or optionally include any mechanism, component, or feature of any of the previously described deployable fusion devices.

21st Deployable Healing Device FIG. 99 provided herein is a 21st deployable healing device 1000y for implantation between two adjacent vertebrae. Optionally, in any embodiment, the device of FIG. 95a is: an actuator including a drive mechanism and a vertical axis; a wedge assembly coupled to the actuator; a ramp assembly slidably coupled to the wedge assembly; a slidable coupling to the ramp assembly. Includes an upper end plate assembly; and a lower end plate assembly that is slidably coupled to the lamp assembly. Optionally, in any embodiment, the 21st deployable fusion device 1000y creates a gap 101y between at least one of the upper end plate assembly and the lower end plate assembly and at least one of the proximal and distal wedges. include. Optionally, in any embodiment, the gap 101y allows the device 1000y to simultaneously deploy width and height.

Optionally, in any embodiment, at least one of the actuator, wedge assembly, lamp assembly, upper end plate assembly, and lower end plate assembly is titanium, cobalt, stainless steel, tantalum, platinum, PEEK, PEKK, carbon fiber, Includes barium sulfate, hydroxyapatite, ceramics, zirconium oxide, silicon nitride, carbon, bone grafts, desalted bone matrix products, synthetic bone substitutes, bone forming agents, bone growth-inducing materials or any combination thereof.

Optionally, in any embodiment, due to the lack of a slidable connection between the wedge assembly and at least one of the upper end plate assembly and the lower end plate assembly, both the height and width of the device 1000y are relative to them. Allows to increase to the limit. Optionally, in any embodiment, the height and width of 1000y increase at the same rate when the actuator is actuated in the first direction.

Optionally, in any embodiment, the actuation of the drive mechanism by the first actuation number in the first actuation direction increases both the height and width of the device 1000x by the same percentage. Optionally, in any embodiment, the actuation of the drive mechanism by the first actuation number in the first actuation direction increases both the height and width of the device 1000x at different rates.

Optionally, in any embodiment, the twentieth deployable fusion device 1000x can further or optionally include any mechanism, component, or feature of any of the previously described deployable fusion devices.
Terms and definitions

Unless otherwise defined, all technical terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this disclosure belongs.

As used herein, the singular forms "a", "an", and "the" include multiple references unless the context explicitly indicates otherwise. References to "or" herein are intended to include "and / or" unless otherwise stated.

As used herein, the term "about" refers to an amount of 10%, 5%, or close to 1% of the amount described, including increments therein.

As used herein, the term "longitudinal axis" refers to a theoretical axis in space that includes the axis of rotational symmetry of an object.

As used herein, the term "slidably coupled" refers to a relationship between two or more components in which the components share at least one degree of freedom.

As used herein, the term "external width" refers to the width between the outermost surfaces of an object.

As used herein, the term "external distance" refers to the distance between the outermost surfaces of an object.

As used herein, the term "apex" refers to the maximum value of a distance, measurement, or parameter.

As used herein, the term "thread feature" refers to one or more spiral or spiral protrusions or recesses that can act as or connect to another thread mechanism. ..

Claims (33)

A deployable fusion device implanted between two adjacent vertebrae , the device is:
Actuator including drive mechanism and vertical axis;
A wedge assembly coupled to an actuator, said wedge assembly that provides increased width of the device;
A lamp assembly that is slidably coupled to a wedge assembly and that results in an increase in the height of the device;
Upper end plate assembly that is slidably coupled to the ramp assembly; and lower end plate assembly that is slidably coupled to the ramp assembly;
Including
Here the device has a width that includes the outer width of at least one of the upper end plate assembly and the lower end plate assembly;
Here the device has a height that includes the external distance between the upper end plate assembly and the lower end plate assembly;
The device increases the width without increasing the height by moving the first wedge a first distance towards or away from the second wedge. Also, the first wedge is moved further toward the second wedge by a second distance beyond the first distance, or the first wedge is moved away from the second wedge by the first distance. Further movement by a second distance beyond is configured to increase the height,
The device. Further movement of the first wedge beyond the first distance by a second distance towards or away from the second wedge can be performed.
The device of claim 1, which increases both height and width. Further movement of the first wedge towards or away from the second wedge by a third distance beyond the first and second distances can be widthwise. The device according to claim 1, wherein the height is increased without increasing the height. The device of claim 1, wherein the width of the device reaches the limit when the drive mechanism is actuated by at least the first actuation number. The device of claim 1, wherein the height of the device reaches its limit when the drive mechanism is actuated by at least the first and second actuation numbers. The device of claim 4, wherein the height of the device is increased by up to 400 % when the drive mechanism is actuated in the first actuation direction by at least the first actuation number. The device according to claim 5, wherein the width of the device is increased by up to 150% when the drive mechanism is operated in the first operating direction by at least the first and second operating numbers. The actuator has a distal end and a proximal end, at least a portion of the distal end contains a first thread mechanism, and at least a portion of the proximal end contains a second thread mechanism, the proximal end. The device according to claim 1, wherein the device includes a drive mechanism. The device according to claim 8, wherein at least one of the first thread mechanism and the second thread mechanism includes a thread arranged outside the periphery of the actuator. The device according to claim 8, wherein the first thread mechanism and the second thread mechanism have opposite thread cutting directions. The device of claim 1, wherein the wedge assembly comprises a distal wedge and a proximal wedge. 11. The device of claim 11, wherein the actuation of the drive mechanism in the first direction brings the distal wedge and the proximal wedge closer to each other. The actuator has a distal end and a proximal end, at least a portion of the distal end contains a first thread mechanism, and at least a portion of the proximal end contains a second thread mechanism, the proximal end. 11. The apparatus of claim 11, wherein the device comprises a drive mechanism, the distal wedge includes a third thread mechanism, and the third thread mechanism is screwed into the first thread mechanism. The actuator has a distal end and a proximal end, at least a portion of the distal end contains a first thread mechanism, and at least a portion of the proximal end contains a second thread mechanism, the proximal end. 11. The apparatus of claim 11, wherein the device comprises a drive mechanism, the proximal wedge includes a fourth thread mechanism, and the fourth thread mechanism is screwed into a second thread mechanism. 13. The device of claim 13, wherein the third thread mechanism comprises a thread disposed within the distal wedge. 14. The device of claim 14, wherein the fourth thread mechanism comprises a thread disposed within a proximal wedge. The device of claim 1, wherein the lamp assembly comprises a first distal lamp, a second distal lamp, a first proximal lamp and a second proximal lamp. 11. Device. 18. The apparatus of claim 18, wherein the angle across the vertical axis is greater than 0 ° and less than 90 °. A slideable connection between the wedge assembly and the lamp assembly, the lamp assembly and the upper end plate assembly, and at least one of the lamp assembly and the lower end plate assembly includes a protrusion and a slot, where the protrusion includes a wedge assembly, a lamp. The device of claim 1, wherein the apparatus extends from at least one of the assembly, the upper end plate assembly and the lower end plate assembly, and the slot is located in at least one of the upper end plate assembly and the lower end plate assembly. 20. The device of claim 20, wherein the protrusion comprises a pin, ridge, dimple, bolt, screw, bearing or any combination thereof. 20. The device of claim 20, wherein the slot comprises a through slot, a blind slot, a t-slot, a v-slot, a groove or any combination thereof. The device of claim 1, wherein the drive mechanism comprises a recessed area configured to receive the drive instrument. The device of claim 1, wherein the drive mechanism comprises a protrusion configured to extend from the drive mechanism and be connected to the drive instrument. 24. The device of claim 24, wherein the protrusion comprises a hexagonal, hexarobula, threaded or square protrusion . The device of claim 1, wherein the upper end plate assembly comprises a first end plate and a second end plate, and the lower end plate assembly comprises a third end plate and a fourth end plate. First end plate and second end plate, third end plate and fourth end plate, first proximal lamp and second proximal lamp, and first distal lamp and second 26. The device of claim 26, wherein at least one of the distal lamps has mirror equivalence. 26. The apparatus of claim 26, wherein at least one of the second end plate and the fourth end plate is larger than at least one of the first end plate and the third end plate. 26. The device of claim 26, wherein at least one outer surface of the first end plate, the second end plate, the third end plate and the fourth end plate comprises a texture configured to grip the vertebrae. .. 29. The apparatus of claim 29, wherein the texture is a tooth, a ridge, a rough surface area, a metal coating, a ceramic coating, a keel, a spike, a protrusion, a groove or any combination thereof. At least one of the actuator, wedge assembly, lamp assembly, upper end plate assembly and lower end plate assembly is titanium, cobalt, stainless steel, tantalum, platinum, PEEK, PEKK, carbon fiber, barium sulfate, hydroxyapatite, ceramic, zirconium oxide. The apparatus of claim 1, comprising silicon nitride, carbon, bone grafts, desalted bone matrix products, synthetic bone substitutes, bone forming agents, bone growth-inducing materials or any combination thereof. A deployable fusion system for two adjacent intervertebral implants, the system including an inserter and a deployable fusion device, the device is:
Actuator including drive mechanism;
Wedge assembly that increases the width of the device;
Lamp assembly that increases the height of the device;
Includes upper end plate assembly; and lower end plate assembly
Here, the device has a width including an external distance between the first end plate and the third end plate, and at least one of the second end plate and the fourth end plate.
Here the device has a height that includes an external distance between the first end plate and the second end plate, as well as at least one of the third end plate and the fourth end plate.
The device increases the width without increasing the height by moving the first wedge towards or away from the second wedge by a first distance. again,
Moving the first wedge further towards the second wedge by a second distance beyond the first distance, or a second distance beyond the first distance in the direction away from the second wedge. The system said that only further movement is configured to increase the height. 32. The system of claim 32, further comprising a folding tool.

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